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Possibilities of contrast-free magnetic resonance perfusion imaging for the detection of early brain damage in essential hypertension

https://doi.org/10.14412/2074-2711-2018-1-17-23

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Abstract

Arterial spin labeling (ASL) is a promising non-invasive method to assess cerebral perfusion, which identifies a decrease in cerebral blood flow (CBF).

Objective: to assess cerebral perfusion in middle-aged untreated patients with uncomplicated grade 1–2 hypertension compared to same-age healthy controls.

Patients and methods. 33 patients with essential hypertension and 40 healthy individuals (a control group) at the age of 40–59 years were examined. 24-hour blood pressure (BP) monitoring and brain magnetic resonance imaging were performed in different modes (T1 MPRAGE, T2 TSE, T2 FLAIR, DTI, and ASL).

Results. White matter hyperintensive changes were found in 7.5% of the healthy individuals and in 51.5% of the hypertensive patients (p = 0.0002). In hypertensive patients, CBF in the cortical plate of anterior frontal regions was significantly (p < 0.001) lower than that in the controls: right CBF, 39.1±5.6 and 45.8±3.2 ml/100 g/min, respectively; left CBF, 39.2±6.2 and 45.2±3.6 ml/100 g/min, respectively. In hypertensive patients with white matter hyperintensive changes, CBF was significantly lower than that in the controls: right CBF, 38.5±5.9 ml/100 g/min (p = 0.0001); left CBF, 39.2±6.7 ml/100 g/min (p = 0.002), and in those without these changes, right CBF was 39.5±5.1 ml/100 g/min (p = 0.0002); left CBF was 38.9±4.3 ml/100 g/min (p = 0.00002). Correlation analysis revealed significant inverse correlations of CBF with BP and systolic BP variability.

Conclusion. Lower cerebral perfusion occurs in middle-aged untreated patients with uncomplicated grade 1–2 hypertension even in the absence of white matter hyperintensity foci. 

About the Authors

T. M. Ostroumova
I.M. Sechenov First Moscow State Medical University (Sechenov University), Ministry of Health of Russia
Russian Federation
11, Rossolimo St., Moscow 119021


V. A. Parfenov
I.M. Sechenov First Moscow State Medical University (Sechenov University), Ministry of Health of Russia
Russian Federation
11, Rossolimo St., Moscow 119021


O. D. Ostroumova
I.M. Sechenov First Moscow State Medical University (Sechenov University), Ministry of Health of Russia; A.I. Evdokimov Moscow State University of Medicine and Dentistry, Ministry of Health of Russia
Russian Federation

11, Rossolimo St., Moscow 119021;

20, Delegatskaya St., Build. 1, Moscow 127423



E. M. Perepelova
I.M. Sechenov First Moscow State Medical University (Sechenov University), Ministry of Health of Russia
Russian Federation
11, Rossolimo St., Moscow 119021


V. A. Perepelov
I.M. Sechenov First Moscow State Medical University (Sechenov University), Ministry of Health of Russia
Russian Federation
11, Rossolimo St., Moscow 119021


E. V. Borisova
E.O. Mukhin City ClinicalHospital, Moscow Healthcare Department
Russian Federation
17, Federativnyi Prospect, Moscow 111399


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For citation:


Ostroumova T.M., Parfenov V.A., Ostroumova O.D., Perepelova E.M., Perepelov V.A., Borisova E.V. Possibilities of contrast-free magnetic resonance perfusion imaging for the detection of early brain damage in essential hypertension. Neurology, Neuropsychiatry, Psychosomatics. 2018;10(1):17-23. (In Russ.) https://doi.org/10.14412/2074-2711-2018-1-17-23

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ISSN 2074-2711 (Print)
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