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September 17, 2025

Evaluation of Cerebrovascular Reactivity Damage Using Resting-State BOLD in Symptomatic Patients with Unilateral MCA/ICA Occlusion

Key Points

CVR-AI demonstrated improved diagnostic performance for predicting surgical outcomes in patients.
Mean CVR and CVR-AI were assessed using resting-state BOLD MRI in 45 patients and 20 controls.
The study indicates that CVR measurement can be clinically feasible without gas-related tasks.
Findings suggest a new hemodynamic marker for risk stratification in intracranial artery occlusion cases.

Abstract

Motivation: Cerebral vascular reserve (CVR) is an independent risk factor for patients with intracranial artery occlusion. CVR measurement using resting-state blood oxygenation level-dependent (RS BOLD) MRI shows clinical potential without gas-related tasks. Still, its feasibility has not been comprehensively evaluated. Goal(s): Achieve clinically feasible CVR marker for risk stratification in patients with intracranial artery occlusion. Approach: We adopted 45 patients with unilateral intracranial artery occlusion and 20 controls; 16 patients were followed up after surgery. Mean CVR and CVR-AI were calculated using RS BOLD in the perfusion territories of bilateral MCA. Results: CVR-AI showed better diagnostic performance and potential value in predicting surgical outcomes. Impact: This study proposes a new hemodynamic marker (CVR-AI) for risk stratification in patients with unilateral intracranial arterial occlusion and promotes the feasibility of measuring CVR using RS BOLD.

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