Detection of leptomeningeal collateral blood flow has high clinical relevance, but clinically applicable imaging methods are lacking. While a novel approach based on coefficient of variance (CoV) analysis of dynamic susceptibility contrast (DSC) MRI was recently proposed, relations to hemodynamic alterations remained unknown. Moreover, the role of leptomeningeal collaterals in internal carotid artery stenosis (ICAS) is under debate. We present multi-parametric hemodynamic evaluation within high CoV-voxels from 29 asymptomatic ICAS-patients and 30 age-matched healthy controls. Our results suggest no enhanced leptomeningeal collateral recruitment in asymptomatic ICAS. However, hemodynamic characteristics imply detection of voxels that are prone to future leptomeningeal recruitment.
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