Detecting the Subregion Proceeding to Infarction in Hypoperfused Cerebral Tissue: a Study with Diffusion and Perfusion Weighted MRI

Overview

Journal Neuroradiology

Specialties Neurology
Radiology

Date 2003 May 17

PMID 12750863

Citations 4

Authors

Y Liu

J O Karonen

R L Vanninen

J Nuutinen

J Perkio

P A Vainio

S Soimakallio

H J Aronen

Affiliations

Soon will be listed here.

Abstract

Diffusion and perfusion weighted MRI have been widely used in ischaemic stroke. We studied 17 patients in whom ischaemic areas showed an ischaemic core, an area of infarct growth and hypoperfused but ultimately surviving tissue. Apparent diffusion coefficients (ADC) were measured on days 1, 2, and 8 in the three subregions and in contralateral control areas. Cerebral blood flow (CBF), cerebral blood volume (CBV), and mean transit time (MTT) were measured in these regions on day 1 perfusion maps. On day 1, the ischaemic core had very low ADC and CBF and increased MTT. The ADC in the ischaemic core gradually increased during the week. The area of infarct growth on day 1 had slightly but significantly decreased ADC (96% of control, P=0.028), moderately decreased CBF and increased MTT. On day 1 the hypoperfused but surviving tissue had slightly but significantly increased ADC (103% of control, P=0.001), mildly decreased CBF and increased CBV and MTT. The ADC of the area of infarct growth decreased to the same level as in the ischaemic core on days 2 and 8. That of surviving tissue was still above normal on day 2 (103% of control), but had returned to the normal level by day 8. Measurement of ADC combined with perfusion MRI may help distinguish different subregions in acutely hypoperfused brain.

Citing Articles

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References

Parsons M, Yang Q, Barber P, Darby D, Desmond P, Gerraty R . Perfusion magnetic resonance imaging maps in hyperacute stroke: relative cerebral blood flow most accurately identifies tissue destined to infarct. Stroke. 2001; 32(7):1581-7. DOI: 10.1161/01.str.32.7.1581. View

Xue M, Ng T, Majors A, Furlan A, Awad I, Jones S . Sensitivity of magnetic resonance diffusion-weighted imaging and regional relationship between the apparent diffusion coefficient and cerebral blood flow in rat focal cerebral ischemia. Stroke. 1995; 26(4):667-74; discussion 674-5. DOI: 10.1161/01.str.26.4.667. View

Marks M, Tong D, Beaulieu C, Albers G, de Crespigny A, Moseley M . Evaluation of early reperfusion and i.v. tPA therapy using diffusion- and perfusion-weighted MRI. Neurology. 1999; 52(9):1792-8. DOI: 10.1212/wnl.52.9.1792. View

Moseley M, Cohen Y, Mintorovitch J, Chileuitt L, Shimizu H, Kucharczyk J . Early detection of regional cerebral ischemia in cats: comparison of diffusion- and T2-weighted MRI and spectroscopy. Magn Reson Med. 1990; 14(2):330-46. DOI: 10.1002/mrm.1910140218. View

Wirestam R, Borg M, Brockstedt S, Lindgren A, Holtas S, Stahlberg F . Perfusion-related parameters in intravoxel incoherent motion MR imaging compared with CBV and CBF measured by dynamic susceptibility-contrast MR technique. Acta Radiol. 2001; 42(2):123-8. View

Pierce A, Lo E, Mandeville J, Gonzalez R, Rosen B, Wolf G . MRI measurements of water diffusion and cerebral perfusion: their relationship in a rat model of focal cerebral ischemia. J Cereb Blood Flow Metab. 1997; 17(2):183-90. DOI: 10.1097/00004647-199702000-00008. View

Li F, Liu K, Silva M, Omae T, Sotak C, Fenstermacher J . Transient and permanent resolution of ischemic lesions on diffusion-weighted imaging after brief periods of focal ischemia in rats : correlation with histopathology. Stroke. 2001; 31(4):946-54. DOI: 10.1161/01.str.31.4.946. View

Miyabe M, Mori S, van Zijl P, Kirsch J, Eleff S, Koehler R . Correlation of the average water diffusion constant with cerebral blood flow and ischemic damage after transient middle cerebral artery occlusion in cats. J Cereb Blood Flow Metab. 1996; 16(5):881-91. DOI: 10.1097/00004647-199609000-00012. View

Le Bihan D, Breton E, lAllemand D, Aubin M, VIGNAUD J, LAVAL-JEANTET M . Separation of diffusion and perfusion in intravoxel incoherent motion MR imaging. Radiology. 1988; 168(2):497-505. DOI: 10.1148/radiology.168.2.3393671. View

10.

Norris D, Kohno K, Mies G, Leibfritz D, Hossmann K . Evolution of regional changes in apparent diffusion coefficient during focal ischemia of rat brain: the relationship of quantitative diffusion NMR imaging to reduction in cerebral blood flow and metabolic disturbances. J Cereb Blood Flow Metab. 1995; 15(6):1002-11. DOI: 10.1038/jcbfm.1995.126. View

11.

Baird A, Benfield A, Schlaug G, Siewert B, Lovblad K, Edelman R . Enlargement of human cerebral ischemic lesion volumes measured by diffusion-weighted magnetic resonance imaging. Ann Neurol. 1997; 41(5):581-9. DOI: 10.1002/ana.410410506. View

12.

Marchal G, Benali K, Iglesias S, Viader F, Derlon J, Baron J . Voxel-based mapping of irreversible ischaemic damage with PET in acute stroke. Brain. 1999; 122 ( Pt 12):2387-400. DOI: 10.1093/brain/122.12.2387. View

13.

Furlan M, Marchal G, Viader F, Derlon J, Baron J . Spontaneous neurological recovery after stroke and the fate of the ischemic penumbra. Ann Neurol. 1996; 40(2):216-26. DOI: 10.1002/ana.410400213. View

14.

Ostergaard L, Weisskoff R, Chesler D, Gyldensted C, Rosen B . High resolution measurement of cerebral blood flow using intravascular tracer bolus passages. Part I: Mathematical approach and statistical analysis. Magn Reson Med. 1996; 36(5):715-25. DOI: 10.1002/mrm.1910360510. View

15.

Pantano P, Baron J, Duquesnoy N, Bousser M, Comar D . Regional cerebral blood flow and oxygen consumption in human aging. Stroke. 1984; 15(4):635-41. DOI: 10.1161/01.str.15.4.635. View

16.

Ernst T, Chang L, Itti L, Speck O . Correlation of regional cerebral blood flow from perfusion MRI and spect in normal subjects. Magn Reson Imaging. 1999; 17(3):349-54. DOI: 10.1016/s0730-725x(98)00171-4. View

17.

Marchal G, Beaudouin V, Rioux P, De La Sayette V, Le Doze F, Viader F . Prolonged persistence of substantial volumes of potentially viable brain tissue after stroke: a correlative PET-CT study with voxel-based data analysis. Stroke. 1996; 27(4):599-606. DOI: 10.1161/01.str.27.4.599. View

18.

Marchal G, Furlan M, Beaudouin V, Rioux P, Hauttement J, Serrati C . Early spontaneous hyperperfusion after stroke. A marker of favourable tissue outcome?. Brain. 1996; 119 ( Pt 2):409-19. DOI: 10.1093/brain/119.2.409. View

19.

Pierpaoli C, Righini A, Linfante I, Tao-Cheng J, Alger J, DI CHIRO G . Histopathologic correlates of abnormal water diffusion in cerebral ischemia: diffusion-weighted MR imaging and light and electron microscopic study. Radiology. 1993; 189(2):439-48. DOI: 10.1148/radiology.189.2.8210373. View

20.

Ostergaard L, Sorensen A, Kwong K, Weisskoff R, Gyldensted C, Rosen B . High resolution measurement of cerebral blood flow using intravascular tracer bolus passages. Part II: Experimental comparison and preliminary results. Magn Reson Med. 1996; 36(5):726-36. DOI: 10.1002/mrm.1910360511. View