We present a novel pulse sequence and modeling algorithm to quantify the water exchange rate (kw) across the BBB without contrast, and to evaluate its clinical utility in a cohort of elderly subjects at risk of cerebral small vessel disease (SVD). A diffusion preparation module was integrated with pseudo-continuous ASL (pCASL) with background suppressed 3D GRASE readout. The results showed good reproducibility of kw measurements (ICC=0.75) in elderly subjects with repeated scans ~2 weeks apart. Average kw was increased in subjects with diabetes and hypercholesterolemia, and was correlated with vascular risk factors, cognitive function and white matter hyperintensities.
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