Arterial CO2 pressure changes during hypercapnia are associated with changes in brain parenchymal volume
European Radiology Experimental, vol. 4, pp. 17
Abstract
The Monro-Kellie hypothesis (MKH) states that volume changes in any intracranial component (blood, brain tissue, cerebrospinal fluid) should be counterbalanced by a co-occurring opposite change to maintain intracranial pressure within the fixed volume of the cranium. In this feasibility study, we investigate the MKH application to structural magnetic resonance imaging (MRI) in observing compensating intracranial volume changes during hypercapnia, which causes an increase in cerebral blood volume. Seven healthy subjects aged from 24 to 64 years (median 32), 4 males and 3 females, underwent a 3-T three-dimensional T1-weighted MRI under normocapnia and under hypercapnia. Intracranial tissue volumes were computed. According to the MKH, the significant increase in measured brain parenchymal volume (median 6.0 mL; interquartile range 4.5, 8.5; p = 0.016) during hypercapnia co-occurred with a decrease in intracranial cerebrospinal fluid (median -10.0 mL; interquartile range -13.5, -6.5; p = 0.034). These results convey several implications: (i) blood volume changes either caused by disorders, anaesthesia, or medication can affect outcome of brain volumetric studies; (ii) besides probing tissue displacement, this approach may assess the brain cerebrovascular reactivity. Future studies should explore the use of alternative sequences, such as three-dimensional T2-weighted imaging, for improved quantification of hypercapnia-induced volume changes.
Authors 5
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Lisa A. van der Kleij corresponding
Utrecht University · University Medical Center Utrecht
Affiliation as printed
Department of Radiology, University Medical Center Utrecht, Utrecht University, Heidelberglaan 100, 3508 GA, Utrecht, The Netherlands. L.vanderKleij-4@umcutrecht.nl
Department of Radiology, University Medical Center Utrecht, Utrecht University, Heidelberglaan 100, 3508 GA, Utrecht, The Netherlands
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National Institutes of Health · National Institute of Neurological Disorders and Stroke
Affiliation as printed
National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, USA
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Leiden University Medical Center
Affiliation as printed
Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands
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Utrecht University · University Medical Center Utrecht
Affiliation as printed
Department of Radiology, University Medical Center Utrecht, Utrecht University, Heidelberglaan 100, 3508 GA, Utrecht, The Netherlands
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Utrecht University · University Medical Center Utrecht · Spinoza Centre for Neuroimaging
Affiliation as printed
Department of Radiology, University Medical Center Utrecht, Utrecht University, Heidelberglaan 100, 3508 GA, Utrecht, The Netherlands
Spinoza Center for Neuroimaging, Amsterdam, The Netherlands
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