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Effect of Cerebrovascular Risk Factors on Regional Cerebral Blood Flow¹

¹ From the Department of Radiology (P.J.v.L., W.P.T.M.M., J.v.d.G., J.H.) and Julius Center for Health Science and Primary Care (Y.v.d.G.), University Medical Center Utrecht, PO Box 85500, 3508 GA Utrecht, the Netherlands. Received November 13, 2006; revision requested January 17, 2007; revision received January 30; accepted March 16; final version accepted May 9. Address correspondence to P.J.v.L. (e-mail: p.j.vanlaar{at}umcutrecht.nl).

Purpose: To prospectively investigate which cerebrovascular risk factors are related to regional cerebral blood flow (rCBF), as measured noninvasively with arterial spin-labeling (ASL) magnetic resonance (MR) imaging, in a large group of patients with symptomatic atherosclerotic disease.

Materials and Methods: Ethics committee approval and informed consent were obtained. One hundred thirty consecutive patients (107 men, 23 women; mean age, 58 years ± 10 [standard deviation]) with symptomatic atherosclerotic disease were included in the study. Cerebrovascular risk factors (body mass index, carotid artery stenosis, diabetes mellitus, hyperhomocysteinemia, hyperlipidemia, hypertension, and smoking) were assessed by means of a questionnaire and physical, ultrasonographic, and laboratory examinations. The control group consisted of 10 subjects (eight men, two women; mean age, 58 years ± 15) without symptomatic atherosclerotic disease. rCBF measurements were performed with ASL MR imaging. The effects of the individual cerebrovascular risk factors on the rCBF were assessed by using linear regression analysis.

Results: Hypertension was significantly associated with higher rCBF (adjusted β = 6.5 mL/min/100 g; 95% confidence interval: 1.4 mL/min/100 g, 11.7 mL/min/100 g). Hyperhomocysteinemia was significantly related to lower rCBF (adjusted β = –7.4 mL/min/100 g; 95% confidence interval: –12.7 mL/min/100 g, –2.1 mL/min/100 g). No significant associations between rCBF and the other cerebrovascular risk factors were found.

Conclusion: In patients with symptomatic atherosclerotic disease, hypertension is related to higher rCBF and hyperhomocysteinemia is related to lower rCBF.

© RSNA, 2007