Increased cerebral oxygen extraction fraction (OEF) in cerebrovascular disease is linked with a greatly elevated risk of recurrent ischemic stroke. The current gold standard for OEF imaging is Oxygen-15 PET; which is less widely available and more expensive than MRI, and includes an ionizing radiation dose. We studied quantitative susceptibility mapping derived OEF maps and R2* mapping combined with an Acetazolamide challenge in a group of unilateral CVD patients, and found increased OEF and reduced cerebrovascular reactivity in the disease-affected hemisphere using these methods. With further refinement, these techniques may provide a clinical alternative to 15O-PET for OEF imaging.
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