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Abstract #1598

Blood-brain barrier filter exchange imaging (BBB-FEXI) detects altered water exchange rates in cerebral small vessel disease

Elizabeth Powell1, Mark Maskery2, Paddy J Slator3,4, David Higgins5, Hedley Emsley2, Laura M Parkes6,7, and Geoff JM Parker1,8
1Medical Physics & Biomedical Engineering, University College London, London, United Kingdom, 2Lancaster Medical School, Lancaster University, Lancaster, United Kingdom, 3Cardiff University Brain Research Imaging Centre, School of Psychology, Cardiff University, Cardiff, United Kingdom, 4School of Computer Science and Informatics, Cardiff University, Cardiff, United Kingdom, 5Philips UK, London, United Kingdom, 6Division of Psychology, Communication and Human Neuroscience, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, United Kingdom, 7Geoffrey Jefferson Brain Research Centre, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, United Kingdom, 8Bioxydyn Limited, Manchester, United Kingdom

Synopsis

Keywords: White Matter, Permeability, Blood-brain barrier

Motivation: Cerebral small vessel disease (cSVD) is a chronic condition affecting the brain microvasculature; subtle blood-brain barrier (BBB) damage is increasingly recognised as a key mechanism in its pathogenesis. Water exchange (WEX) rate measurement techniques are emerging as potential alternatives to conventional gadolinium contrast-enhanced approaches, and may provide a more sensitive assessment of subtle BBB dysfunction.

Goal(s): To assess BBB WEX rates in cSVD.

Approach: We use the BBB filter exchange imaging (BBB-FEXI) technique to measure WEX rates in ten cSVD and ten healthy controls.

Results: Higher WEX was observed in cSVD subjects than in healthy controls.

Impact: BBB-FEXI was sensitive to BBB water exchange and microstructural alterations in cSVD. This may provide insight into the diffuse and heterogeneous disease process of cSVD, where there is often minimal agreement between clinical and radiological findings, ultimately improving patient prognosis.

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Keywords