Cervical vertigo related cerebral blood flow change revealed by three dimensional pseudo continuous arterial spin labeling

Abstract

Objective To quantitatively investigate the change of cerebral blood flow (CBF)induced by cervical vertigo by using 3D pseudo-continuous arterial spin labeling (3D PCASL).Methods This study included 17 patients without cerebral arterial stenosis on MRA as the patient group and 14 healthy volunteers as the control group.They were examined by 3D PCASL before and after the vertigo-inducing test respectively.CBF was measured in regions of interest (ROI) which were perfused by bilateral anteroinferior cerebellar artery (AICA),posteroinferior cerebellar artery (PICA),superior cerebellar artery (SCA),posterior cerebral artery (PCA),middle cerebral artery (MCA),anterior cerebral artery (ACA) and posterior pons.The change of CBF caused by the vertigo-inducing test was calculated for every ROI.Independent t test was used to compare the change of CBF between the patients and controls.Results There was significant difference of change of CBF in the ROIs of R-PICA,R-AICA,R-ACA,bilateral SCA,bilateral PCA territory and posterior pons between the patients and controls (t =2.30 to 3.99,P ＜ 0.05).CBF values in these ROIs were significantly decreased after the vertigo-inducing test in the patients.The changes of CBF in ROIs of patients and controls were as following:(1) R-PICA (-3.86 ± 6.43) vs.(0.63 ±4.37) ml/(min · 100 g) ; (2) R-AICA (-4.30 ±6.79) vs.(0.39 ±3.51) ml/(min · 100 g) ;(3) SCA:(-7.15 ±6.70) vs.(-0.27 ±3.89) ml/(min · 100 g) for the left side,(6.99 ±6.34) vs.(-0.68±3.18) ml/(min · 100 g) for the right side; (4) PCA:(-7.39 ±6.31) vs.(-0.39 ±3.24) ml/(min· 100g) for the left side,(-7.86±6.48) vs.(-1.41±2.91) ml/(min· 100 g) for the right side; (5) R-ACA (-3.50 ±4.03) vs.(0.16 ±3.07) m]/(min · 100 g) ; (6) posterior pons (-5.91 ±7.34) vs.(0.06 ± 3.41) ml/(min · 100 g).Conclusions 3D PCASL is able to detect the CBF change induced by vertigo-inducing test.Cervical vertigo onset is related to posterior circulation ischemia,which may be caused by the spinal position changes. Key words: Vertigo; Cervical spondylosis; Magnetic resonance imaging