Arterial Spin Labeling and Blood Oxygen Level-Dependent MRI Cerebrovascular Reactivity in Cerebrovascular Disease: A Systematic Review and Meta-Analysis

Cerebrovasc Dis. 2016;42(3-4):288-307. doi: 10.1159/000446081. Epub 2016 May 31.

Abstract

Background: The cerebrovascular reactivity (CVR) results of blood oxygen level-dependent (BOLD) and arterial spin labeling (ASL) MRI studies performed in patients with cerebrovascular disease (steno-occlusive vascular disease or stroke) were systematically reviewed.

Summary: Thirty-one articles were included. Twenty-three (74.2%) studies used BOLD MRI to evaluate the CVR, 4 (12.9%) studies used ASL MRI and 4 (12.9%) studies used both BOLD and ASL MRI. Thirteen studies (3 significant) found a lower BOLD CVR, 2 studies found a similar CVR and 3 studies found a higher CVR in the ipsilateral compared to the contralateral hemisphere. Nine (5 significant) out of 10 studies found a lower BOLD CVR in the ipsilateral hemispheres of patients compared to controls. Six studies (2 significant) found a lower ASL CVR in the ipsilateral compared to the contralateral hemispheres. Three out of 5 studies found a significant lower ASL CVR in the ipsilateral hemispheres of patients compared to controls.

Key messages: This review brings support for a reduced BOLD and ASL CVR in the ipsilateral hemisphere of patients with cerebrovascular disease. We suggest that future studies will be performed in a uniform way so reference values can be established and could be used to guide treatment decisions in patients with cerebrovascular disease.

Publication types

  • Meta-Analysis
  • Review
  • Systematic Review

MeSH terms

  • Biomarkers / blood
  • Blood Flow Velocity
  • Cerebrovascular Circulation*
  • Cerebrovascular Disorders / blood
  • Cerebrovascular Disorders / diagnostic imaging*
  • Cerebrovascular Disorders / physiopathology
  • Cerebrovascular Disorders / therapy
  • Chi-Square Distribution
  • Energy Metabolism
  • Hemodynamics*
  • Humans
  • Magnetic Resonance Imaging*
  • Oxygen / blood*
  • Oxygen Consumption*
  • Perfusion Imaging / methods*
  • Predictive Value of Tests
  • Prognosis
  • Spin Labels*
  • Vasodilation

Substances

  • Biomarkers
  • Spin Labels
  • Oxygen