Normalised time-to-peak-distribution curves correlate with cerebral white matter hyperintensities - Could this improve early diagnosis?

Christian Nasel, Roland Boubela, Klaudius Kalcher, Ewald Moser

Research output: Journal article (peer-reviewed)Journal article

8 Citations (Scopus)


Parameter-free assessment of the time-to-peak (TTP) histogram, termed 'TTP-distribution curve' (TDC), of dynamic susceptibility contrast-enhanced magnetic resonance imaging (DSC-MRI) was introduced as a robust method to evaluate cerebral perfusion. TDC-assessment works fully automatically without the need of an arterial input function, thereby providing full comparability between different measurements. In the investigated sample of 106 patients, a strong dependency of TDC on the hemodynamic state of cerebral microvessels and the arterio-venous bolus-transit time [Formula: see text] was demonstrated. Accordingly, TDC-derived [Formula: see text] was 3.3-3.7 s for control patients and 4.4 s for cerebral small vessel disease patients. Measurements of associated bolus spread velocities ν and accelerations [Formula: see text] additionally revealed a direct effect from spin-spin relaxation time T2-weighted white matter hyperintensity volume, considered to indicate microangiopathy in cerebral small vessel disease, on the TDC-measurements. This strongly supports the prevailing hypothesis that cerebral small vessel disease directly influences DSC-measurements, where the degree could be estimated from an analysis of TDC. While this may be used to correct DSC-parameters for undesirable effects from cerebral small vessel disease, it could also serve to potentially identify patients at risk for cerebral small vessel disease at an early stage, since a subset of patients without yet significant WHM-volume, but clearly altered hemodynamics in TDC-measurements, was identified in this study.

Original languageEnglish
Pages (from-to)444-455
Number of pages12
JournalJournal of Cerebral Blood Flow and Metabolism
Issue number2
Publication statusPublished - Feb 2017


  • Cerebral Small Vessel Diseases/diagnostic imaging
  • Cerebrovascular Circulation/physiology
  • Early Diagnosis
  • Hemodynamics
  • Humans
  • Magnetic Resonance Angiography/methods
  • Magnetic Resonance Imaging/methods
  • White Matter/diagnostic imaging
  • cerebral small vessel disease
  • perfusion imaging
  • perfusion magnetic resonance imaging
  • Brain perfusion
  • leukoaraiosis

ASJC Scopus subject areas

  • Neurology (clinical)
  • Neurology
  • Cardiology and Cardiovascular Medicine


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