ArticleAJNR. American journal of neuroradiology2025
Susceptibility Changes on Preoperative Acetazolamide-Loaded 7T MR Quantitative Susceptibility Mapping Predict Post-Carotid Endarterectomy Cerebral Hyperperfusion.
Article in AJNR. American journal of neuroradiology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
background and purposePost-carotid endarterectomy (CEA) cerebral hyperperfusion (CH) can cause intracerebral hemorrhage and cognitive decline. Alterations in susceptibility in response to acetazolamide (ACZ) on 7T MRI quantitative susceptibility mapping (QSM) detect elevated CBV occurring due to impaired cerebrovascular autoregulation. We explored preoperative relative susceptibility changes on 7T MRI QSM in response to ACZ and their ability to predict CH following CEA. MATERIALS AND
methodsSixty-three patients with uni- or bilateral cervical ICA stenosis of ≥70% underwent 7T MRI at baseline and at 5, 10, 15, and 20 minutes after ACZ administration before surgery. The difference between the susceptibility of venous structures and surrounding brain parenchyma at each time point after ACZ administration relative to the difference at baseline (relative susceptibility difference [RSD]) on QSM images was calculated in the cerebral hemisphere ipsilateral to the surgery site. Brain perfusion SPECT was conducted preoperatively and immediately following CEA to detect postoperative CH (≥100% rise in CBF postoperatively).
resultsIn 9 patients with postoperative CH, the RSD was significantly increased at 5 or 10 minutes following ACZ administration (
conclusionsChanges in susceptibility on preoperative 7T MRI QSM following ACZ administration predict CH following CEA. Patients with increased RSD
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