Brain capillary transit time heterogeneity in healthy volunteers measured by dynamic contrast-enhanced T₁-weighted perfusion MRI

TY - JOUR

T1 - Brain capillary transit time heterogeneity in healthy volunteers measured by dynamic contrast-enhanced T1-weighted perfusion MRI

AU - Larsson, Henrik B.W.

AU - Vestergaard, Mark B.

AU - Lindberg, Ulrich

AU - Iversen, Helle K.

AU - Cramer, Stig P.

PY - 2017/6

Y1 - 2017/6

N2 - Purpose: Capillary transit time heterogeneity, measured as CTH, may set the upper limit for extraction of substances in brain tissue, e.g., oxygen. The purpose of this study was to investigate the feasibility of dynamic contrast-enhanced T1 weighted MRI (DCE-MRI) at 3 Tesla (T), in estimating CTH based on a gamma-variate model of the capillary transit time distribution. In addition, we wanted to investigate if a subtle increase of the blood–brain barrier permeability can be incorporated into the model, still allowing estimation of CTH. Materials and Methods: Twenty-three healthy subjects were scanned at 3.0T MRI system applying DCE-MRI and using a gamma-variate model to estimate CTH as well as cerebral blood flow (CBF), cerebral blood volume (CBV), and permeability of the blood–brain barrier, measured as the influx constant Ki. For proof of principle we also investigated three patients with recent thromboembolic events and a patient with a high grade brain tumor. Results: In the healthy subjects, we found a narrow symmetric delta-like capillary transit time distribution in basal ganglia gray matter with median CTH of 0.93 s and interquartile range of 1.33 s. The corresponding residue impulse response function was compatible with the adiabatic tissue homogeneity model. In two patients with complete occlusion of the internal carotid artery and in the patient with a brain tumor CTH was increased with values up to 6 s in the affected brain tissue, with an exponential like residue impulse response function. Conclusion: Our results open the possibility of characterizing brain perfusion by the capillary transit time distribution using DCE-MRI, theoretically a determinant of efficient blood to brain transport of important substances. Level of Evidence: 2. J. MAGN. RESON. IMAGING 2017;45:1809–1820.

AB - Purpose: Capillary transit time heterogeneity, measured as CTH, may set the upper limit for extraction of substances in brain tissue, e.g., oxygen. The purpose of this study was to investigate the feasibility of dynamic contrast-enhanced T1 weighted MRI (DCE-MRI) at 3 Tesla (T), in estimating CTH based on a gamma-variate model of the capillary transit time distribution. In addition, we wanted to investigate if a subtle increase of the blood–brain barrier permeability can be incorporated into the model, still allowing estimation of CTH. Materials and Methods: Twenty-three healthy subjects were scanned at 3.0T MRI system applying DCE-MRI and using a gamma-variate model to estimate CTH as well as cerebral blood flow (CBF), cerebral blood volume (CBV), and permeability of the blood–brain barrier, measured as the influx constant Ki. For proof of principle we also investigated three patients with recent thromboembolic events and a patient with a high grade brain tumor. Results: In the healthy subjects, we found a narrow symmetric delta-like capillary transit time distribution in basal ganglia gray matter with median CTH of 0.93 s and interquartile range of 1.33 s. The corresponding residue impulse response function was compatible with the adiabatic tissue homogeneity model. In two patients with complete occlusion of the internal carotid artery and in the patient with a brain tumor CTH was increased with values up to 6 s in the affected brain tissue, with an exponential like residue impulse response function. Conclusion: Our results open the possibility of characterizing brain perfusion by the capillary transit time distribution using DCE-MRI, theoretically a determinant of efficient blood to brain transport of important substances. Level of Evidence: 2. J. MAGN. RESON. IMAGING 2017;45:1809–1820.

KW - blood–brain barrier

KW - capillary transit time heterogeneity

KW - cerebral hemodynamics

KW - MRI

KW - perfusion weighted MRI

U2 - 10.1002/jmri.25488

DO - 10.1002/jmri.25488

M3 - Journal article

C2 - 27731907

AN - SCOPUS:84991112195

SN - 1053-1807

VL - 45

SP - 1809

EP - 1820

JO - Journal of Magnetic Resonance Imaging

JF - Journal of Magnetic Resonance Imaging

IS - 6

ER -