Mapping cerebrovascular hemodynamics with MRI: insights in hemodynamic variation in health and disease

Abstract

The aim of this thesis was to obtain better insight in the relation between hemodynamics and vascular structure and function in the cerebrovasculature in healthy subjects, in patients with an unruptured intracranial aneurysm (UIA) and in patients with other types of (cerebro)vascular disease. To investigate hemodynamic markers, we used 2D phase-contrast (PC) and 4D PC flow imaging on both 3T and 7T MR field. Hemodynamics and anatomy are directly related to each other in healthy subjects as shown in Chapter 2 and 3, but also in UIA as described in Chapter 5 and 6. However, in cerebrovascular disease (CVD) hemodynamics and anatomy can behave differently, as demonstrated by our findings that show the added value of studying hemodynamics and morphology together. Chapter 7 showed that no effective pulsatility attenuation by the carotid siphon was seen in patients with cerebral small vessel disease (cSVD). Considering the influence of ICA calcification on pulsatility dampening as shown in Chapter 7, the results in Chapter 8 showed that the pulsatility along the ICA siphon is still normally damped in patients with pseudoxanthoma elasticum (PXE). This shows that hemodynamics and morphology in different CVD disease can behave differently along the cerebrovascular tree. Therefore, studying hemodynamics and morphology helps to obtain better understanding of the CVD, and might help in the future for better diagnosis or prognosis of the disease.