We applied 3D diffusion-prepared pseudo-continuous arterial spin labeling (DP-pCASL) to evaluate water exchange rate (kw) of blood brain barrier (BBB) and its association with clinical characteristics of cerebral autosomal recessive arteriopathy with subcortical infarcts and leukoencephalopathy (CARASIL) patients. The CARASIL group showed significantly decreased kw and cerebral blood flow (CBF) compared with healthy controls. The association between kw with age, CBF and white matter hyperintensity volumes (WMH) found in CARASIL patients suggest that kw could be a potential non-contrast imaging biomarker for BBB dysfunction in cerebral small vessel disease.
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