Approaches to Brain Stress Testing BOLD Magnetic Resonance Imaging with Computer-Controlled Delivery of Carbon Dioxide 英文参考文献.docVIP

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Approaches to Brain Stress Testing BOLD Magnetic Resonance Imaging with Computer-Controlled Delivery of Carbon Dioxide 英文参考文献.doc

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Approaches to Brain Stress Testing BOLD Magnetic Resonance Imaging with Computer-Controlled Delivery of Carbon Dioxide 英文参考文献

ApproachestoBrainStressTesting:BOLDMagnetic ResonanceImagingwithComputer-ControlledDelivery ofCarbonDioxide W.AlanC.Mutch1*,DanielM.Mandell2,JosephA.Fisher3,DavidJ.Mikulis2,AdrianP.Crawley2, OliviaPucci4,JamesDuffin3 1Department of Anesthesia and Perioperative Medicine, University of Manitoba, Winnipeg, Canada, 2Department of Medical Imaging, Neuroradiology, University of Toronto,Toronto,Canada,3DepartmentofAnesthesia,UniversityofToronto,Toronto,Canada,4ThornhillResearchInc.,UniversityofToronto,Toronto,Canada Abstract Background:Animpairedvascularresponseinthebrainregionallymayindicatereducedvascularreserveandvulnerability toischemicinjury.Changingthecarbondioxide(CO2)tensioninarterialbloodiscommonlyusedasacerebralvasoactive stimulus to assess the cerebral vascular response, changing cerebral blood flow (CBF) by up to 5–11 percent/mmHg in normaladults.HerewedescribetwoapproachestogeneratingtheCO2challengeusingacomputer-controlledgasblender toadminister:i)asquarewavechangeinCO2and,ii)arampstimulus,consistingofacontinuouslygradedchangeinCO2 overarange.Responseswereassessedregionallybybloodoxygenleveldependent(BOLD)magneticresonanceimaging (MRI). Methodology/PrincipalFindings:Westudied8patientswithknowncerebrovasculardisease(carotidstenosisorocclusion) and2healthysubjects.Thesquarewavestimuluswasusedtostudythedynamicsofthevascularresponse,whiletheramp stimulusassessedthesteady-stateresponsetoCO2.Cerebrovascularreactivity(CVR)mapswereregisteredbycolorcoding andoverlaidontheanatomicalscansgeneratedwith3TeslaMRItoassessthecorrespondingBOLDsignalchange/mmHg change in CO2, voxel-by-voxel. Using a fractal temporal approach, detrended fluctuation analysis (DFA) maps of the processed raw BOLD signal per voxel over the same CO2 range were generated. Regions of BOLD signal decrease with increasedCO2(codedblue)wereseeninallofthesehigh-riskpatients,indicatingregionsofimpairedCVR.Allpatientsalso demonstratedregionsofalteredsignalstructureonDFAmaps(Hurstexponentslessthan0.5;codedb