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Abstract #4906

Normalization for Relative Cerebrovascular Reactivity in Multifocal Vascular Disease Patients Using Calibrated Perfusion and Temporal Shift

Xiuyuan Wang1, Siddhant Dogra2, Koto Ishida3, Alejandro Gupta2, Deqiang Qiu4, and Seena Dehkharghani2,3
1Department of Radiology, Weill Cornell Medicine, New York, NY, United States, 2Department of Radiology, New York University Langone Health, New York, NY, United States, 3Department of Neurology, New York University Langone Health, New York, NY, United States, 4Department of Radiology and Imaging Sciences, Emory University, Atlanta, GA, United States


Cerebrovascular reactivity (CVR) is a widely used estimation of hemodynamic stress and ischemic stroke risk but its semi-quantitative nature relegates it primarily to estimations of relative change by comparison to putatively normal territories. Diagnostic and prognostic utility is thus attenuated in commonly encountered patients with bihemispheric disease, thus we have tested approaches for identification of candidate healthy voxels accompanying perfusion imaging or inline calibration of BOLD temporal shift, optimized in a cohort of subjects with strictly unilateral macrovascular disease. Excellent agreement with normative CVR values was observed, suggesting its applicability in patients with multi-focal or ambiguous vascular disease patterns.

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