Although this is a small study, it demonstrates that carotid stent fractures do exist, and importantly, not all of them are benign. Therefore, the authors recommend regular surveillance with plain radiography in addition to duplex ultrasonography to enable early detection of fracturing. Following detection, institution of increased surveillance frequency and/or any appropriate intervention can be implemented, to aid in the prevention of complications resulting from restenosis should it become apparent.
Background
High fat feeding (HFF) is a risk factor for Alzheimer’s disease (AD), and acute meal studies including lipid tolerance tests can be used to understand mechanisms by which diet affects disease processes. This study seeks to describe cerebral blood flow (CBF) response using arterial spin labeling (ASL) MRI, given the tight coupling of CBF to brain metabolism.
Method
After fasting, 16 older adults (age 66.3±2.9) underwent baseline and 1, 2, 3‐hour ASL MRI after ingestion of 1/2 cup heavy cream with comparable total and saturated fat to a high fat breakfast. We used pCASL MRI with background suppression to measure CBF in ml/100g/min. Imaging parameters were in accordance with the recommendations of ISMRM: label duration = 1.8 s, post‐labeling delay = 2 s, labeling offset = 25‐30 mm, slices = 20, resolution = 3.5×3.5×5 mm3, SENSE‐factor = 2, TR/TE= 5000/18 ms. Finally, we acquired a reference scan (M0, 1 minute) identical to the above scan but with TR = 10,000 ms and no labeling or background suppression. Statistical analyses included paired t tests and ANOVA for group comparisons.
Result
Global CBF decreased at 1, 2, and 3 hours post‐lipid drink, compared to time 0 (1h:‐2.12±4.1, 2h:‐1.9±3.2, 3h:‐2.9±3.1); only 2 and 3 hours were statistically lower. No group differences by sex or APOE status were noted in baseline or change CBF for this small pilot sample.
Conclusion
Global CBF decreased after lipid ingestion, similar to what has been reported with glucose and fructose ingestion. Sustained decreases in CBF were still detectable at 3 hours. Future studies include investigation of pre‐post CBF in various regions known to be affected by AD.
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