Functional MR Imaging in Patients with Carotid Artery Stenosis before and after Revascularization

Significant extracranial stenosis of the ICA is a known risk factor for future stroke and it has been shown that revascularization reduces the risk of future stroke. We applied BOLD fMRI in patients with carotid artery stenosis before and after CEA. Our purpose was to determine whether fMRI is able to demonstrate impaired CVR and to identify patient parameters that are associated with postoperative changes of cerebral hemodynamics.Nineteen consecutive patients with symptomatic (n = 13) and asymptomatic (n = 6) stenosis of the ICA were prospectively recruited (male/female ratio = 16:3; age, 69 ? 8,1 years). fMRI using a simple bilateral motor task was performed immediately before and after CEA.Mean BOLD MSC was significantly increased postoperatively (MSC, 0.13 ? 0.66; P = 0.0002). Patients with a stenosis of 70 years: MSC, 0.29 ? 0.48; P ? .0001).BOLD fMRI can demonstrate changes in cerebral hemodynamics before and after CEA, indicative of an ameliorated CVR. This response is dependent on the age of the patient, the degree of preoperative stenosis, and the patient's symptoms.