A novel quantification method for determining previously undetected silent infarcts on MR-perfusion in patients following carotid endarterectomy

Xin Liu M.D.; Celina Imielinska; Joel Rosiene; Anita Rampersad; Joseph Zurica; David Wilson; Hadi Halazun; Susan C. Williams; Angela Ligneli M.D.; Anthony D'Ambrosio M.D.; Michael Sughrue; E. Sander Connolly Jr.; Eric J. Heyer M.D.

doi:10.1117/12.596623

29 April 2005 A novel quantification method for determining previously undetected silent infarcts on MR-perfusion in patients following carotid endarterectomy

Xin Liu M.D., Celina Imielinska, Joel Rosiene, Anita Rampersad, Joseph Zurica, David Wilson, Hadi Halazun, Susan C. Williams, Angela Ligneli M.D., Anthony D'Ambrosio M.D., Michael Sughrue, E. Sander Connolly Jr., Eric J. Heyer M.D.

Author Affiliations +

Proceedings Volume 5747, Medical Imaging 2005: Image Processing; (2005) https://doi.org/10.1117/12.596623
Event: Medical Imaging, 2005, San Diego, California, United States

Abstract

The purpose of this paper is to evaluate the post-operative Magnetic Resonance Perfusion (MRP) scans of patients undergoing carotid endarterectomy (CEA), using a novel image-analysis algorithm, to determine if post-operative neurocognitive decline is associated with cerebral blood flow changes. CEA procedure reduces the risk of stroke in appropriately selected patients with significant carotid artery stenosis. However, 25% of patients experience subtle cognitive deficits after CEA compared to a control group. It was hypothesized that abnormalities in cerebral blood flow (CBF) are responsible for these cognitive deficits. A novel algorithm for analyzing MR-perfusion (MRP) scans to identify and quantify the amount of CBF asymmetry in each hemisphere was developed and to quantify the degree of relative difference between three corresponding vascular regions in the ipsilateral and contralateral hemispheres, the Relative Difference Map (RDM). Patients undergoing CEA and spine surgery (controls) were examined preoperatively, and one day postoperatively with a battery of neuropsychometric (NPM) tests, and labeled “injured” patients with significant cognitive deficits, and “normal” if they demonstrated no decline in neurocognitive function. There are apparently significant RDM differences with MRP scans between the two hemispheres in patients with cognitive deficits which can be used to guide expert reviews of the imagery. The proposed methodology aids in the analysis of MRP parameters in patients with cognitive impairment.

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Xin Liu M.D., Celina Imielinska, Joel Rosiene, Anita Rampersad, Joseph Zurica, David Wilson, Hadi Halazun, Susan C. Williams, Angela Ligneli M.D., Anthony D'Ambrosio M.D., Michael Sughrue, E. Sander Connolly Jr., and Eric J. Heyer M.D. "A novel quantification method for determining previously undetected silent infarcts on MR-perfusion in patients following carotid endarterectomy", Proc. SPIE 5747, Medical Imaging 2005: Image Processing, (29 April 2005); https://doi.org/10.1117/12.596623

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