TY - JOUR
T1 - Magnetic resonance perfusion imaging in acute middle cerebral artery stroke
T2 - Comparison of blood volume and bolus peak arrival time
AU - Soher, Brian J.
AU - Gillard, Jonathan H.
AU - Bryan, R. Nick
AU - Oppenheimer, Stephen M.
AU - Barker, Peter B.
N1 - Funding Information:
Rapid magnetic resonance imaging (MRI) during bolus injection of gadolinium diethylenetriaminepentaacetic acid (GdDTPA) contrast agent is a promising technique for evaluating cerebral perfusion in patients with cerebrovascular disease. TM In normal brain, the paramagnetic contrast agent GdDTPA remains enclosed within the cerebral vasculature, shortening the longitudinal relaxation time From the Departments of Biomedical Engineering, Radiology, and Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, Received February 12, 1997; accepted June 4,1997. Supported in part by the Whitaker Foundation, Washington, DC. Address reprint requests to Peter B. Barker, D.Phil, Department of Neurology, Henry Ford Hospital, 2799 W Grand Blvd, Detroit, MI 48202. Copyright 9 1998 by National Stroke Association 1052-3057/98/0701-000453.00/0 (T1) of blood, and causing local magnetic field inhomogeneities that shorten the transverse relaxation time constant (T~) in surrounding tissues, s By measuring the temporal evolution of T2* after bolus injection of GdDTPA, it is possible to create images of relative regional cerebral blood volume (rCBV6), and with special acquisition and analysis techniques, blood flow (rCBF). 7-9 Recently, rCBV images have also been created using the blood T1 relaxation effect. 1~ Research has shown that MR perfusion imaging can be used to detect early ischemic changes in acute stroke 2 with much higher sensitivity than conventional MRI. Decreases in blood volume were correlated with the presence of major vessel occlusion as shown by MR angiography (MRA), and were predictive of poor clinical outcome. TM Generally, conventional MRI is relatively insensitive for the early detection of ischemia, 15 and
PY - 1998/1
Y1 - 1998/1
N2 - Ten patients with a diagnosis of acute middle cerebral artery stroke were evaluated using perfusion magnetic resonance imaging (MRI) during bolus injection of gadolinium diethylenetriaminepentaacetic acid (GdDTPA), MR angiography, and conventional MRI. Scans were performed within 24 hours of symptoms, onset, and 5 of the 10 patients had follow-up MR scans 3 or more days later to determine radiological outcome. Perfusion data were analyzed in terms of relative regional cerebral blood volume (rCBV) and bolus peak arrival times (BAT). Although relative rCBV values overall showed no significant changes compared with contralateral regions of interest, BAT was significantly increased in both infarct and peri-infarct regions. Areas of abnormal BAT significantly exceeded areas of T2 hyperintensity in acute studies; follow-up images indicated that the size of infarction increased to include some regions with previously abnormal BAT. BAT appears to be a more sensitive parameter for the detection of abnormal cerebral perfusion than rCBV. Used in conjunction with other MR methods, perfusion MR imaging may allow visualization of ischemic tissue at risk of infarction in acute stroke.
AB - Ten patients with a diagnosis of acute middle cerebral artery stroke were evaluated using perfusion magnetic resonance imaging (MRI) during bolus injection of gadolinium diethylenetriaminepentaacetic acid (GdDTPA), MR angiography, and conventional MRI. Scans were performed within 24 hours of symptoms, onset, and 5 of the 10 patients had follow-up MR scans 3 or more days later to determine radiological outcome. Perfusion data were analyzed in terms of relative regional cerebral blood volume (rCBV) and bolus peak arrival times (BAT). Although relative rCBV values overall showed no significant changes compared with contralateral regions of interest, BAT was significantly increased in both infarct and peri-infarct regions. Areas of abnormal BAT significantly exceeded areas of T2 hyperintensity in acute studies; follow-up images indicated that the size of infarction increased to include some regions with previously abnormal BAT. BAT appears to be a more sensitive parameter for the detection of abnormal cerebral perfusion than rCBV. Used in conjunction with other MR methods, perfusion MR imaging may allow visualization of ischemic tissue at risk of infarction in acute stroke.
KW - Stroke-Perfusion-MRI
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U2 - 10.1016/S1052-3057(98)80017-7
DO - 10.1016/S1052-3057(98)80017-7
M3 - Article
C2 - 17895052
AN - SCOPUS:0346626604
SN - 1052-3057
VL - 7
SP - 17
EP - 23
JO - Journal of Stroke and Cerebrovascular Diseases
JF - Journal of Stroke and Cerebrovascular Diseases
IS - 1
ER -