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A Research Study On Vascular Imaging Video

5 Cases in 5 Minutes: Vascular #2 A Research Study On Vascular Imaging

Background: Cerebral small vessel disease is the most common cause of subcortical vascular dementia SVaD. Unfortunately, conventional imaging techniques do not always demonstrate the microvascular pathology that is associated with small vessel disease.

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The purpose of this study was to evaluate the changes in the microvascular structure of SVaD and to identify how the microvascular changes in vessel size, detected with imaging, affect the gray matter. Methods: Ten SVaD patients and 12 healthy controls underwent vessel size imaging with gradient-echo and spin-echo sequences before and after contrast agent injection. Four microvessel index maps, including total blood volume fraction BVfmean vessel density Qmean vessel diameter mVDand vessel size index VSI were calculated.

Voxel-wise comparison of microvessel parameters was also performed to assess the regional difference. The relationship between the microvessel parameters in white matter and total gray matter volume TGV were assessed.

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Conclusions: The increase of mVD and VSI in SVaD patients reflects the damage of the microvessels in the white matter, and these changes may lead to the damage of the gray matter. Cerebrovascular disease is a major contributor to cognitive decline in the elderly even though here has proven to be somewhat elusive to diagnose. This SVD often occurs with dementia and worsens cognitive impairment. Therefore, dementia is becoming a big health burden 1. SVD of the central nervous system begins with microangiopathies, such as arteriolosclerosis, lipohyalinosis, or fibrinoid necrosis.

These pathologic changes lead to disturbance in the microcirculation and chronic hypoxia in the brain 2 — 4.

Associated Data

The chronic hypoxia results in pathologic changes of white matter, including axonal loss, demyelination, and gliosis, which is represented as hyperintense signals on T2-weighted images T2WIwhich are called white matter hyperintensities WMH 2 — 4. Despite the importance of SVD, the dominant diagnostic tool for this diagnosis relies upon the visual inspection of conventional imaging and neuropsychological tests. Researxh

Unfortunately, it remains difficult to discriminate the pathological changes underlying cognitive decline A Research Study On Vascular Imaging SVD using conventional brain imaging, and brain damage is not always limited to the initially visible lesions 5. Recently, multiple attempts have been made to characterize the microvasculature using perfusion and pharmacokinetics to measure the mean vessel caliber and microvessel density in vivo on MRI. A concept of vessel size imaging originated from the difference in relative cerebral blood volume between the gradient-echo GE and spine-echo SE techniques in gliomas. The GE relaxation rate remains constant although the SE relaxation VVascular decreases with the vessel size. These changes are induced by intravascular super-paramagnetic contrast agents 6. So far, most studies applying this technique have been used to characterize cerebral tumor vascularization 6 — 9.

This technique has also recently been shown to be useful when applied to ischemic stroke ]