Examining the Relationship between Semiquantitative Methods Analysing Concentration-Time and Enhancement-Time Curves from Dynamic-Contrast Enhanced Magnetic Resonance Imaging and Cerebrovascular Dysfunction in Small Vessel Disease.

Jose Bernal,Paul A Armitage,Rhian M Touyz,Joanna M Wardlaw,Stephen Makin,Javier Escudero,María Valdés-Hernández,Eleni Sakka

doi:10.3390/jimaging6060043

Abstract

Dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) can be used to examine the distribution of an intravenous contrast agent within the brain. Computational methods have been devised to analyse the contrast uptake/washout over time as reflections of cerebrovascular dysfunction. However, there have been few direct comparisons of their relative strengths and weaknesses. In this paper, we compare five semiquantitative methods comprising the slope and area under the enhancement-time curve, the slope and area under the concentration-time curve ( and ), and changes in the power spectrum over time. We studied them in cerebrospinal fluid, normal tissues, stroke lesions, and white matter hyperintensities (WMH) using DCE-MRI scans from a cohort of patients with small vessel disease (SVD) who presented mild stroke. The total SVD score was associated with in WMH (), but not with the other four methods. In WMH, we found higher was associated with younger age () and fewer WMH (), whereas increased with younger age () and WMH burden (). Our results show the potential of different measures extracted from concentration-time curves extracted from the same DCE examination to demonstrate cerebrovascular dysfunction better than those extracted from enhancement-time curves.

Highlights

Dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) in the brain is typically considered for examining the integrity of grey and white matter and potential contrast leakage into cerebrospinal fluid (CSF) cavities [1,2,3]
We evaluated the effect of the measures of contrast uptake/washout computed in cerebrospinal fluid and white matter hyperintensities (WMH) against two relevant visual clinical ratings (Fazekas and small vessel disease (SVD) scores)
We compared the performance of five semiquantitative methods for analysing signal-time trajectories of Gadolinium-based contrast agent in reflecting small vessel disease burden within healthy and pathological intracranial brain regions

Summary

Introduction

Dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) in the brain is typically considered for examining the integrity of grey and white matter and potential contrast leakage into cerebrospinal fluid (CSF) cavities [1,2,3] Such trajectories may vary depending on the capillary density and the disruption of the blood–brain barrier or blood–CSF barrier, among other factors. Factors such as scanner signal drift, tissue variations, and imaging artefacts introduce systematic errors hampering quantitative assessments [3,9,10,11]

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