1) Understand the role of breath hold cerebrovascular reactivity (BH CVR) mapping in the assessment of neurovascular uncoupling potential. 2) Appreciate how neurovascular uncoupling may affect the reliability of BOLD fMRI activation maps. 3) Describe how BH CVR mapping can be performed in brain tumor patients.
The phenomenon of neurovascular uncoupling (NVU) is an important limitation of blood oxygen level dependent (BOLD) functional MRI (fMRI). One effective and practical method for assessement of risk of NVU is BOLD breath hold cerebrovascular reactivity (BH CVR) mapping. BH CVR mapping, similar to MR perfusion methods, allows assessment of regional hemodynamic impairment that may result in NVU and thus may lead to false negative activation on task-based sensorimotor or language fMRI that may be used for presurgical mapping in patients with brain tumors and other resectable brain lesions. However, unlike MR perfusion imaging, which assesses static or baseline perfusion to brain tumors and peritumoral regions, BOLD BH CVR mapping enables a dynamic assessment of cerebrovascular response, and its results can be applied to any task-based activation map. This lecture will describe the technique of BH CVR mapping, some of its strengths and limitations, and include cases in which interpretation of clinical fMRI exams has been affected by the additional information provided by these maps.
Pillai, J,
BOLD Cerebrovascular Reactivity Mapping as Applied to Brain Tumor fMRI. Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL.
http://archive.rsna.org/2014/12020966.html
