Highlights
- •Oxygen extraction fraction mapping in normal pressure hydrocephalus patients
- •Oxygen extraction fraction is feasible using multiecho gradient echo MRI.
- •Declined oxygen extraction fraction is correlated with enlarged brain ventricles.
- •Oxygen extraction fraction provides understanding of neurodegeneration.
Abstract
Objective
Normal pressure hydrocephalus (NPH) is a neurodegenerative disease that is potentially
reversible by shunt surgery in approximately 60% of patients. Imaging may provide
a means to investigate brain tissue viability and oxygen metabolism in NPH patients.
Methods
Oxygen extraction fraction (OEF) mapping was generated from 3D multi-echo gradient
echo MRI (mGRE) data using QQ-CCTV algorithm and cerebral blood flow (CBF) using 3D
arterial spin labeling (ASL) MRI data, thereby calculating the cerebral metabolic
rate of oxygen (CMRO2 = CBF × OEF × [H]a) in 16 NPH patients. Regression analyses using cortical gray matter and deep gray
matter regions were conducted with age, gender, CSF stroke volume and normalized ventricular
volume as independent variables.
Results
OEF showed significant negative correlations with normalized brain ventricular volumes
in the whole brain (p = 0.004, q = 0.01), cortical gray matter (p = 0.004, q = 0.01), caudate (p = 0.02, q = 0.04), and pallidum (p = 0.03, q = 0.04), but no significant correlation with CSF stroke volume (q > 0.05).
There was no significant finding with CBF or CMRO2.
Conclusion
In NPH patients, low OEF in several regions was significantly correlated with large
ventricular volumes, indicating decreased tissue oxygen metabolism with increased
NPH severity. OEF mapping may provide a functional understanding of neurodegeneration
in NPH and may improve monitoring of disease course and treatment outcomes.
Keywords
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Article info
Publication history
Published online: February 09, 2023
Accepted:
February 2,
2023
Received in revised form:
January 16,
2023
Received:
August 18,
2022
Identification
Copyright
© 2023 Elsevier Inc. All rights reserved.
