We will discuss how new MRI techniques allow us to identify various stages of brain response to cardiovascular disease.
Outcome / Objectives
Understand how cardiovascular disease impacts brain vascular function through the lens of modern MRI techniques. We will focus on chronic microvascular disease but will include considerations where systemic vascular function may also influence test results. An introduction will cover the basic understanding of the clinical manifestation of microvascular disease and the associated limitations. We will then cover how different vascular measures allow us to probe discrete vascular responses that may shed light into disease properties or allow for earlier detection of abnormalities. We will cover the expected temporal progression of vascular disease on cerebral blood flow, cerebral blood volume, cerebrovascular reactivity, oxygen extraction fraction and cerebral metabolic rate. At the end, the audience should have an understanding for how seemingly disparate measures relate to each other as part of an interconnected physiologic system that strives to maintain homeostasis. We will stress the importance of context in interpreting the meaning of these physiologic tests where the underlying pathophysiology may be quite distinct for chronic disease versus in more acute settings that receive more clinical attention such as workup for stroke or tumor.