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Wong SM, Zhang CE, van Bussel FC, Staals J, Jeukens CR, Hofman PA, van Oostenbrugge RJ, Backes WH, Jansen JF. Simultaneous investigation of microvasculature and parenchyma in cerebral small vessel disease using intravoxel incoherent motion imaging. Neuroimage Clin 2017; 14:216-221. [PMID: 28180080 PMCID: PMC5288390 DOI: 10.1016/j.nicl.2017.01.017] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/18/2016] [Revised: 11/28/2016] [Accepted: 01/16/2017] [Indexed: 01/01/2023]
Abstract
INTRODUCTION Cerebral small vessel disease (cSVD) is associated with microvascular and parenchymal alterations. Intravoxel incoherent motion (IVIM) MRI has been proposed to simultaneously measure both the microvascular perfusion and parenchymal diffusivity. This study aimed to evaluate the application of IVIM in cSVD to assess the microvasculature and parenchymal microstructure. METHODS Seventy-three patients with cSVD (age 70 ± 11 y) and thirty-nine controls (age 69 ± 12 y) underwent IVIM imaging (3T). Group differences of the perfusion volume fraction f and the parenchymal diffusivity D were investigated using multivariable linear regression accounted for age, sex and cardiovascular factors. To examine the relation between the IVIM measures and the disease severity on structural MRI, white matter hyperintensity (WMH) load served as surrogate measure of the disease severity. RESULTS Patients had a larger f (p < 0.024) in the normal appearing white matter (NAWM) than controls. Higher D (p < 0.031) was also observed for patients compared with controls in the NAWM and grey matter. Both f (p < 0.024) and D (p < 0.001) in the NAWM and grey matter increased with WMH load. CONCLUSIONS The increased diffusivity reflects the predicted microstructural tissue impairment in cSVD. Unexpectedly, an increased perfusion volume fraction was observed in patients. Future studies are needed to reveal the precise nature of the increased perfusion volume fraction. IVIM imaging showed that the increases of f and D in cSVD were both related to disease severity, which suggests the potential of IVIM imaging to provide a surrogate marker for the progression of cSVD.
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Key Words
- BMI, body mass index
- Brain parenchyma
- Cerebral small vessel disease
- DGM, deep grey matter
- DW, diffusion weighted
- Diffusion weighted imaging
- FLAIR, fluid attenuated inversion recovery
- FOV, field of view
- IVIM, intravoxel incoherent motion imaging
- Intravoxel incoherent motion imaging
- LS, lacunar stroke
- Microvasculature
- NAWM, normal appearing white matter
- PVS, perivascular spaces
- Perfusion MR imaging
- ROI, region of interest
- SNR, signal-to-noise ratio
- WMH, white matter hyperintensity
- cSVD, cerebral small vessel disease
- mVCI, mild vascular cognitive impairment
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Affiliation(s)
- Sau May Wong
- Dept. of Radiology & Nuclear Medicine, Maastricht University Medical Centre, Maastricht, The Netherlands
- School for Mental Health and Neuroscience (MHeNs), Maastricht University Medical Centre, Maastricht, The Netherlands
| | - C. Eleana Zhang
- Dept. of Neurology, Maastricht University Medical Centre, Maastricht, The Netherlands
- School for Mental Health and Neuroscience (MHeNs), Maastricht University Medical Centre, Maastricht, The Netherlands
- Dept. of Cardiovascular Research Institute Maastricht (CARIM), Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Frank C.G. van Bussel
- Dept. of Radiology & Nuclear Medicine, Maastricht University Medical Centre, Maastricht, The Netherlands
- School for Mental Health and Neuroscience (MHeNs), Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Julie Staals
- Dept. of Neurology, Maastricht University Medical Centre, Maastricht, The Netherlands
- Dept. of Cardiovascular Research Institute Maastricht (CARIM), Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Cécile R.L.P.N. Jeukens
- Dept. of Radiology & Nuclear Medicine, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Paul A.M. Hofman
- Dept. of Radiology & Nuclear Medicine, Maastricht University Medical Centre, Maastricht, The Netherlands
- School for Mental Health and Neuroscience (MHeNs), Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Robert J. van Oostenbrugge
- Dept. of Neurology, Maastricht University Medical Centre, Maastricht, The Netherlands
- School for Mental Health and Neuroscience (MHeNs), Maastricht University Medical Centre, Maastricht, The Netherlands
- Dept. of Cardiovascular Research Institute Maastricht (CARIM), Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Walter H. Backes
- Dept. of Radiology & Nuclear Medicine, Maastricht University Medical Centre, Maastricht, The Netherlands
- School for Mental Health and Neuroscience (MHeNs), Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Jacobus F.A. Jansen
- Dept. of Radiology & Nuclear Medicine, Maastricht University Medical Centre, Maastricht, The Netherlands
- School for Mental Health and Neuroscience (MHeNs), Maastricht University Medical Centre, Maastricht, The Netherlands
- Corresponding author at: Department of Radiology & Nuclear Medicine, Maastricht University Medical Centre, PO Box 5800, 6202 AZ Maastricht, The Netherlands.Department of Radiology & Nuclear MedicineMaastricht University Medical CentrePO Box 5800Maastricht6202 AZThe Netherlands
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