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66th Annual Meeting of the German Society of Neurosurgery (DGNC)
Friendship Meeting with the Italian Society of Neurosurgery (SINch)

German Society of Neurosurgery (DGNC)

7 - 10 June 2015, Karlsruhe

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Assessing cerebral hemodynamics using new non-invasive and quantitative MRI techniques

Meeting Abstract

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  • Jorn Fierstra - Department of Neurosurgery, University Hospital, Zurich, Switzerland
  • Bas van Niftrik - Department of Neurosurgery, University Hospital, Zurich, Switzerland
  • Marco Piccirelli - Department of Neuroradiology, University Hospital, Zurich, Switzerland
  • Jan-Karl Burkhardt - Department of Neurosurgery, University Hospital, Zurich, Switzerland
  • Marian Neidert - Department of Neurosurgery, University Hospital, Zurich, Switzerland
  • Athina Pangalu - Department of Neuroradiology, University Hospital, Zurich, Switzerland
  • Antonios Valavanis - Department of Neuroradiology, University Hospital, Zurich, Switzerland
  • Luca Regli - Department of Neurosurgery, University Hospital, Zurich, Switzerland
  • Oliver Bozinov - Department of Neurosurgery, University Hospital, Zurich, Switzerland

Deutsche Gesellschaft für Neurochirurgie. 66. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC). Karlsruhe, 07.-10.06.2015. Düsseldorf: German Medical Science GMS Publishing House; 2015. DocP 147

doi: 10.3205/15dgnc545, urn:nbn:de:0183-15dgnc5459

Published: June 2, 2015

© 2015 Fierstra et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.

Outline

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Objective: To quantify cerebrovascular autoregulation with a standardized CO2 stimulus, we combined cerebral blood flow (CBF) measurements using Arterial Spin Labeling (ASL) and Blood-oxygen-level-dependent (BOLD) cerebrovascular reactivity (CVR) measurements together with controlled prospective arterial CO2 targeting. We acquired this non-invasive MRI protocol in healthy subjects and neurovascular patients and demonstrate how such studies can be complementary to each other.

Method: Eight healthy subjects (mean age 29.8 ± 3.7) and five patients (mean age 48 ± 11.2) with chronic steno-occlusive disease were scanned on a 3T Skyra MRI system. PaCO2 was manipulated using a prospective end tidal gas targeting during the acquisition of BOLD EPI whole brain volumes. Quantitative CBF was measured during hypocapnia and hypercapnia in two separate dynamic acquisitions of 2D EPI ASL.CVR and CBF maps were created during postprocessing analyses using SPM12 software.

Results: Baseline CO2 values during BOLD acquisitions for healthy subjects and patients were (mean ± std) 40.7 ± 2.1 and 40.6 ± 1.1 respectively and for the hypercapnic phase 51.9 ± 2.5 and 51.7 ± 2.1. Mean CO2 during hypocapnia during the ASL acquistions was 33.6 ± 3.0 and 33.8 ± 2.2 for healthy subjects and patients resp, during hypercapnia 47.4 ± 2.6 and 48.5 ± 2.4. Whole brain CVR for healthy subjects was 0.211 ± 0.045 and for patients 0.159 ± 0.078. Mean CBF increase during ASL sequences with hypercapnia compared to hypocapnia was 89% for healthy subjects and 26% ± 44 for patients with neurovascular disease.

Conclusions: Combining BOLD CVR during a CO2 challenge with quantitative cerebral blood flow changes (as measured with ASL using the same CO2 challenge), in healthy and neurovascular patients, allows a noninvasive complementary assessment of cerebral hemodynamics with high spatial resolution.