Routine clinical evaluation of cerebrovascular reserve capacity in patients with atherosclerotic and non-atherosclerotic intracranial stenosis using carbogen MRI

Carbogen (i.e., 5%CO2/95%O2)-induced measures of CVR are potentially safer than measures elicited by other hypercarbic gas mixtures, owing to abilities of carbogen to increase oxygen delivery to tissue. However, carbogen adds additional complications owing to effects of transient hyperoxia on metabolism and increases in sPO2. Here, we applied a carbogen MRI protocol in intracranial stenosis patients (n=54). Findings demonstrate focal regions of CVR discrepancy between healthy and diseased hemispheres in patients, consistent with angiographic measures of impairment, however only when z-statistic markers of CVR are utilized. However, quantitative interpretation of absolute signal changes is altered by increases in blood [HbO2]/[Hb].

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