Signal changes on magnetic resonance perfusion images with arterial spin labeling after carotid endarterectomy

Takafumi Shimogawa, Takato Morioka, Tetsuro Sayama, Sei Haga, Tomoaki Akiyama, Kei Murao, Yuka Kanazawa, Yoshihiko Furuta, Ayumi Sakata, Shuji Arakawa

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Background: Cerebral hyperperfusion after carotid endarterectomy (CEA) is defined as an increase in ipsilateral cerebral blood flow (CBF). Practically, however, prompt and precise assessment of cerebral hyperperfusion is difficult because of limitations in the methodology of CBF measurement during the perioperative period. Arterial spin labeling (ASL) is a completely noninvasive and repeatable magnetic resonance perfusion imaging technique that uses magnetically-labelled blood water as an endogenous tracer. To clarify the usefulness of ASL in the management of cerebral hyperperfusion, we investigated signal changes by ASL with a single 1.5-s post-labeling delay on visual inspection. Methods: Thirty-two consecutive patients who underwent CEA were enrolled in this retrospective study. Results: On postoperative day 1, 22 (68.8%) and 4 (12.5%) patients exhibited increased ASL signals bilaterally (Group A) and on the operated side (Group B), respectively. Follow-up ASL showed improvement in these findings. Six (18.8%) patients showed no change (Group C). There was no apparent correlation between ASL signals on postoperative day 1 and the preoperative hemodynamic state, including the cerebrovascular reserve (P = 0.2062). Three (9.4%) patients developed cerebral hyperperfusion syndrome (two in Group A and one in Group B). Coincidence in the localization of increased ASL signals and electroencephalographic abnormalities was noted in these patients. Conclusion: Visual analysis of ASL with a single post-labeling delay overestimates CBF and cannot identify patients at risk of cerebral hyperperfusion syndrome probably because of the strong effect of the shortened arterial transit time immediately after CEA. However, ASL may be used as for screening.

Original languageEnglish
Pages (from-to)S1031-S1040
JournalSurgical Neurology International
Volume7
Issue number42
DOIs
Publication statusPublished - Jan 1 2016

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Carotid Endarterectomy
Cerebrovascular Circulation
Magnetic Resonance Spectroscopy
Perfusion
Perioperative Period
Magnetic Resonance Angiography
Retrospective Studies
Hemodynamics
Water

All Science Journal Classification (ASJC) codes

  • Surgery
  • Clinical Neurology

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Signal changes on magnetic resonance perfusion images with arterial spin labeling after carotid endarterectomy. / Shimogawa, Takafumi; Morioka, Takato; Sayama, Tetsuro; Haga, Sei; Akiyama, Tomoaki; Murao, Kei; Kanazawa, Yuka; Furuta, Yoshihiko; Sakata, Ayumi; Arakawa, Shuji.

In: Surgical Neurology International, Vol. 7, No. 42, 01.01.2016, p. S1031-S1040.

Research output: Contribution to journalArticle

Shimogawa, T, Morioka, T, Sayama, T, Haga, S, Akiyama, T, Murao, K, Kanazawa, Y, Furuta, Y, Sakata, A & Arakawa, S 2016, 'Signal changes on magnetic resonance perfusion images with arterial spin labeling after carotid endarterectomy', Surgical Neurology International, vol. 7, no. 42, pp. S1031-S1040. https://doi.org/10.4103/2152-7806.196322
Shimogawa, Takafumi ; Morioka, Takato ; Sayama, Tetsuro ; Haga, Sei ; Akiyama, Tomoaki ; Murao, Kei ; Kanazawa, Yuka ; Furuta, Yoshihiko ; Sakata, Ayumi ; Arakawa, Shuji. / Signal changes on magnetic resonance perfusion images with arterial spin labeling after carotid endarterectomy. In: Surgical Neurology International. 2016 ; Vol. 7, No. 42. pp. S1031-S1040.
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abstract = "Background: Cerebral hyperperfusion after carotid endarterectomy (CEA) is defined as an increase in ipsilateral cerebral blood flow (CBF). Practically, however, prompt and precise assessment of cerebral hyperperfusion is difficult because of limitations in the methodology of CBF measurement during the perioperative period. Arterial spin labeling (ASL) is a completely noninvasive and repeatable magnetic resonance perfusion imaging technique that uses magnetically-labelled blood water as an endogenous tracer. To clarify the usefulness of ASL in the management of cerebral hyperperfusion, we investigated signal changes by ASL with a single 1.5-s post-labeling delay on visual inspection. Methods: Thirty-two consecutive patients who underwent CEA were enrolled in this retrospective study. Results: On postoperative day 1, 22 (68.8{\%}) and 4 (12.5{\%}) patients exhibited increased ASL signals bilaterally (Group A) and on the operated side (Group B), respectively. Follow-up ASL showed improvement in these findings. Six (18.8{\%}) patients showed no change (Group C). There was no apparent correlation between ASL signals on postoperative day 1 and the preoperative hemodynamic state, including the cerebrovascular reserve (P = 0.2062). Three (9.4{\%}) patients developed cerebral hyperperfusion syndrome (two in Group A and one in Group B). Coincidence in the localization of increased ASL signals and electroencephalographic abnormalities was noted in these patients. Conclusion: Visual analysis of ASL with a single post-labeling delay overestimates CBF and cannot identify patients at risk of cerebral hyperperfusion syndrome probably because of the strong effect of the shortened arterial transit time immediately after CEA. However, ASL may be used as for screening.",
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T1 - Signal changes on magnetic resonance perfusion images with arterial spin labeling after carotid endarterectomy

AU - Shimogawa, Takafumi

AU - Morioka, Takato

AU - Sayama, Tetsuro

AU - Haga, Sei

AU - Akiyama, Tomoaki

AU - Murao, Kei

AU - Kanazawa, Yuka

AU - Furuta, Yoshihiko

AU - Sakata, Ayumi

AU - Arakawa, Shuji

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N2 - Background: Cerebral hyperperfusion after carotid endarterectomy (CEA) is defined as an increase in ipsilateral cerebral blood flow (CBF). Practically, however, prompt and precise assessment of cerebral hyperperfusion is difficult because of limitations in the methodology of CBF measurement during the perioperative period. Arterial spin labeling (ASL) is a completely noninvasive and repeatable magnetic resonance perfusion imaging technique that uses magnetically-labelled blood water as an endogenous tracer. To clarify the usefulness of ASL in the management of cerebral hyperperfusion, we investigated signal changes by ASL with a single 1.5-s post-labeling delay on visual inspection. Methods: Thirty-two consecutive patients who underwent CEA were enrolled in this retrospective study. Results: On postoperative day 1, 22 (68.8%) and 4 (12.5%) patients exhibited increased ASL signals bilaterally (Group A) and on the operated side (Group B), respectively. Follow-up ASL showed improvement in these findings. Six (18.8%) patients showed no change (Group C). There was no apparent correlation between ASL signals on postoperative day 1 and the preoperative hemodynamic state, including the cerebrovascular reserve (P = 0.2062). Three (9.4%) patients developed cerebral hyperperfusion syndrome (two in Group A and one in Group B). Coincidence in the localization of increased ASL signals and electroencephalographic abnormalities was noted in these patients. Conclusion: Visual analysis of ASL with a single post-labeling delay overestimates CBF and cannot identify patients at risk of cerebral hyperperfusion syndrome probably because of the strong effect of the shortened arterial transit time immediately after CEA. However, ASL may be used as for screening.

AB - Background: Cerebral hyperperfusion after carotid endarterectomy (CEA) is defined as an increase in ipsilateral cerebral blood flow (CBF). Practically, however, prompt and precise assessment of cerebral hyperperfusion is difficult because of limitations in the methodology of CBF measurement during the perioperative period. Arterial spin labeling (ASL) is a completely noninvasive and repeatable magnetic resonance perfusion imaging technique that uses magnetically-labelled blood water as an endogenous tracer. To clarify the usefulness of ASL in the management of cerebral hyperperfusion, we investigated signal changes by ASL with a single 1.5-s post-labeling delay on visual inspection. Methods: Thirty-two consecutive patients who underwent CEA were enrolled in this retrospective study. Results: On postoperative day 1, 22 (68.8%) and 4 (12.5%) patients exhibited increased ASL signals bilaterally (Group A) and on the operated side (Group B), respectively. Follow-up ASL showed improvement in these findings. Six (18.8%) patients showed no change (Group C). There was no apparent correlation between ASL signals on postoperative day 1 and the preoperative hemodynamic state, including the cerebrovascular reserve (P = 0.2062). Three (9.4%) patients developed cerebral hyperperfusion syndrome (two in Group A and one in Group B). Coincidence in the localization of increased ASL signals and electroencephalographic abnormalities was noted in these patients. Conclusion: Visual analysis of ASL with a single post-labeling delay overestimates CBF and cannot identify patients at risk of cerebral hyperperfusion syndrome probably because of the strong effect of the shortened arterial transit time immediately after CEA. However, ASL may be used as for screening.

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