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Research ArticleFunctionalE

Functional MR Imaging in Patients with Carotid Artery Stenosis before and after Revascularization

M. Schaaf, G. Mommertz, A. Ludolph, S. Geibprasert, G. Mühlenbruch, M. Das and T. Krings
American Journal of Neuroradiology November 2010, 31 (10) 1791-1798; DOI: https://doi.org/10.3174/ajnr.A2219
M. Schaaf
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G. Mommertz
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A. Ludolph
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S. Geibprasert
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G. Mühlenbruch
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M. Das
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T. Krings
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  • Fig 1.
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    Fig 1.

    BOLD SCs in all patients before and after CEA. There is a significant increase in BOLD SC after revascularization, testifying to an ameliorated cerebrovascular reactivity.

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    Fig 2.

    Pre- and postoperative BOLD signal-intensity curves of patients with ICA stenosis of ≤70% (A); ≤80% (B), ≤90% (C), and ≤99% (D). Dashed lines demonstrate the preoperative and solid lines, the postoperative data. There are significant differences in pre- and postoperative curves in A and B (low-grade stenoses), and no significant increase in BOLD SC in C and D (high-grade stenoses).

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    Fig 3.

    BOLD signal-intensity curves of symptomatic (solid line) and asymptomatic (dashed line) patients demonstrates that symptomatic patients have a lower degree of activation than asymptomatic patients preoperatively. Postoperatively, their BOLD signal-intensity curve exceeds that of asymptomatic patients.

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    Fig 4.

    BOLD signal-intensity curves of patients with minor (A) and severe (B) symptoms of ICA stenosis. Preoperative BOLD SCs are similar in both patient groups. Postoperative changes in BOLD signal intensity are stronger in patients with previous stroke compared with patients with previous TIA.

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    Fig 5.

    Comparison of BOLD signal-intensity curves in patients who are younger (A) and older (B) than 70 years. In contrast to younger patients, older patients present with a significant benefit of CEA and the degree of signal-intensity drop following sustained activity is less pronounced.

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    Table 1:

    Patient demographic data and BOLD signal gain and change for percentage ICA stenosis

    Subject/ Sex/Age (yr)Presenting SymptomsDays between Presenting Symptoms and First MRIDegree of StenosisBOLD Signal GainPre (BOLD %SC) ± SDPost (BOLD %SC) ± SDT2WI and DWI Findings
    Symp SideSymp Side
    1/F/66NoneN/A90700.020.685 ± 0.150.704 ± 0.18Chronic microangiopathy
    2/F/57NoneN/A8570−0.111.618 ± 0.31.507 ± 0.35Chronic microangiopathy
    3/M/78Stroke109000.071.4 ± 0.321.471 ± 0.53Acute cortical ischemic stroke and chronic microangiopathy
    4/M/77Stroke128001.10.271 ± 0.291.361 ± 0.33Acute deep white matter ischemic stroke
    5/M/72AF198000.160.775 ± 0.190.932 ± 0.30Chronic microangiopathy
    6/M/62NoneN/A850−0.680.543 ± 0.18-0.139 ± 0.12Chronic microangiopathy
    7/M/62NoneN/A9585−0.481.021 ± 0.360.543 ± 0.18Chronic microangiopathy
    8/M/81TIA167000.211.323 ± 0.321.528 ± 0.4Chronic microangiopathy
    9/M/69AF14900−0.120.814 ± 0.230.693 ± 0.2Chronic microangiopathy
    10/M/71AF8900−0.140.832 ± 0.120.693 ± 0.2Acute cortical ischemic stroke and microangiopathy
    11/M/72TIA197000.270.924 ± 0.291.195 ± 0.41Chronic microangiopathy
    12/M/78Stroke259000.720.569 ± 0.141.291 ± 0.23Chronic microangiopathy
    13/M/66NoneN/A8000.11.095 ± 0.291.193 ± 0.23Chronic microangiopathy
    14/M/80Stroke56080−0.150.961 ± 0.710.815 ± 0.33Acute cortical ischemic stroke and microangiopathy
    15/F/74Stroke695650.410.632 ± 0.161.038 ± 0.27Acute deep white matter ischemic stroke
    16/M/66NoneN/A8000.021.085 ± 0.311.107 ± .29Chronic microangiopathy
    17/M/67Stroke127001.320.753 ± 0.172.076 ± 0.67Acute deep white matter ischemic stroke
    18/M/66AF7950−0.061.141 ± 0.271.079 ± 0.21Chronic microangiopathy
    19/M/50Stroke9550−0.11.172 ± 0.311.068 ± 0.23Acute cortical ischemic stroke
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    Table 2:

    Mean BOLD SCs in all patient groups

    Mean BOLD PreSDMean BOLD PostSDMSCSDPValue
    Stenosis
        ≤70%1.030.441.340.610.310.61.001
        ≤80%0.810.431.150.320.340.50.000
        ≤90%0.990.440.990.48−0.010.39.453
        ≤100%0.770.340.660.61−0.110.50.100
    Stroke/TIA/AF
        Stroke0.820.491.300.540.550.65.000
        TIA/AF0.970.321.020.410.050.26.054
    Symp/asymp
        Asymp1.010.440.820.58−0.190.35.000
        Symp0.890.421.170.500.280.55.000
    Age
        ≤70 yr0.990.390.980.64−0.010.56.429
        >70 yr0.850.461.150.430.290.48.000
    All0.930.431.060.550.130.66.002
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American Journal of Neuroradiology: 31 (10)
American Journal of Neuroradiology
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1 Nov 2010
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Cite this article
M. Schaaf, G. Mommertz, A. Ludolph, S. Geibprasert, G. Mühlenbruch, M. Das, T. Krings
Functional MR Imaging in Patients with Carotid Artery Stenosis before and after Revascularization
American Journal of Neuroradiology Nov 2010, 31 (10) 1791-1798; DOI: 10.3174/ajnr.A2219

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Functional MR Imaging in Patients with Carotid Artery Stenosis before and after Revascularization
M. Schaaf, G. Mommertz, A. Ludolph, S. Geibprasert, G. Mühlenbruch, M. Das, T. Krings
American Journal of Neuroradiology Nov 2010, 31 (10) 1791-1798; DOI: 10.3174/ajnr.A2219
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