Purpose: To clarify whether diffusion-weighted imaging using stretched exponential model can assess cerebrovascular reserve (CVR) in patients with major cerebral artery steno-occlusive disease, we compared stretched exponential parameters and single-photon emission computed tomography (SPECT).
Methods: Twenty-nine patients with unilateral major cerebral artery steno-occlusive disease (25 men and 4 women; age, 69±11 years) were analyzed in this study. The patients were divided into three groups: normal CVR (CVR≥30%), moderate CVR (10%≤CVR<30%), and severe CVR (CVR<10%). The distributed diffusion coefficient (DDC) and heterogeneity index (α) from the stretched exponential model, apparent diffusion coefficient (ADC) from the monoexponential model, and CVR and resting cerebral blood flow (CBF) from SPECT were measured in the bilateral middle cerebral artery territories, and ipsilateral-to-contralateral ratios (rDDC, rα, rADC, and rCBF) were obtained.
Results: The rDDC values in severe CVR were significantly higher than those in normal CVR (P=0.003). The rDDC values were significantly negatively correlated with ipsilateral CVR (rho=-0.31, P=0.009). The rDDC values were not significantly correlated with rCBF (P=0.34).
Conclusion: We have shown that elevated rDDC values are associated with impaired CVR. Our results suggest that diffusion-weighted imaging using stretched exponential model has a potential to evaluate hemodynamic impairment.
Keywords: cerebrovascular reserve (CVR); diffusion-weighted imaging (DWI); major cerebral artery steno-occlusive disease; single-photon emission computed tomography (SPECT); stretched exponential model.