Blood oxygen‐level dependent functional assessment of cerebrovascular reactivity: Feasibility for intraoperative 3 Tesla MRI

• Published in: Magnetic resonance in medicine Vol. 77; no. 2; pp. 806 - 813
• Main Authors: Fierstra, Jorn, Burkhardt, Jan‐Karl, van Niftrik, Christiaan Hendrik Bas, Piccirelli, Marco, Pangalu, Athina, Kocian, Roman, Neidert, Marian Christoph, Valavanis, Antonios, Regli, Luca, Bozinov, Oliver
• Format: Journal Article
• Language: English
• Published: United States Wiley Subscription Services, Inc 01.02.2017
• Subjects: 3 Tesla; Adult; Apnea; Blood; Brain; Brain - blood supply; Brain - diagnostic imaging; Brain mapping; Cerebrovascular Circulation - physiology; cerebrovascular reactivity; Color; Feasibility studies; Female; Field strength; hemodynamics; Humans; intraoperative; Intraoperative Neurophysiological Monitoring - methods; Magnetic resonance imaging; Magnetic Resonance Imaging - methods; Male; Middle Aged; MRI; Neurosurgery; Oxygen - blood; Oxygen - metabolism; Reactivity; Spatial discrimination; Spatial resolution; Young Adult; intraoperative; 3 Tesla; cerebrovascular reactivity; brain; MRI; hemodynamics
• ISSN: 0740-3194; 1522-2594
• DOI: 10.1002/mrm.26135

Purpose To assess the feasibility of functional blood oxygen‐level dependent (BOLD) MRI to evaluate intraoperative cerebrovascular reactivity (CVR) at 3 Tesla field strength. Methods Ten consecutive neurosurgical subjects scheduled for a clinical intraoperative MRI examination were enrolled in this study. In addition to the clinical protocol a BOLD sequence was implemented with three cycles of 44 s apnea to calculate CVR values on a voxel‐by‐voxel basis throughout the brain. The CVR range was then color‐coded and superimposed on an anatomical volume to create high spatial resolution CVR maps. Results Ten subjects (mean age 34.8 ± 13.4; 2 females) uneventfully underwent the intraoperative BOLD protocol, with no complications occurring. Whole‐brain CVR for all subjects was (mean ± SD) 0.69 ± 0.42, whereas CVR was markedly higher for tumor subjects as compared to vascular subjects, 0.81 ± 0.44 versus 0.33 ± 0.10, respectively. Furthermore, color‐coded functional maps could be robustly interpreted for a whole‐brain assessment of CVR. Conclusion We demonstrate that intraoperative BOLD MRI is feasible in creating functional maps to assess cerebrovascular reactivity throughout the brain in subjects undergoing a neurosurgical procedure. Magn Reson Med 77:806–813, 2017. © 2016 International Society for Magnetic Resonance in Medicine