Multivariate analysis of perfusion and oxygenation patterns in asymptomatic unilateral carotid artery stenosis

Asymptomatic internal carotid artery stenosis (ICAS) is linked with increased stroke risk and cognitive decline. Physiological MRI of cerebral hemodynamic changes in ICAS patients is promising to inform treatment decisions. Here, we investigated the complex pathophysiology of ICAS using principal component analysis of cerebral perfusion and oxygenation changes to establish disease-specific patterns of CBF, OEF, CMRO2 and the effective oxygen diffusivity of the capillary bed. Regression models revealed the association of pattern expression with sonography-based degree of stenosis and flow velocity in the carotid artery, as well as systemic blood pressure.