MRI assessment of cerebral blood volume in patients with brain infarcts

Abstract

MRI perfusion studies have focussed mainly on acute ischaemia and characterisation in ischaemia. Our purpose was to analyse regional brain haemodynamic information in acute, subacute, and chronic ischaemia. We performed 16 examinations of 11 patients on a 1.5 T MR images. Conventional and dynamic contrast-enhanced imaging were employed in all examinations. For the dynamic susceptibility sequences, a bolus (0.2 mmol/kg) of gadopentetate dimeglumine was injected. Reconstructed regional relative cerebral blood volume (rCBV) maps, bolus maps, and conventional images were analysed by consensus reading. In all examinations decreases in rCBV were observed in the lesions. The distribution of regional rCBV in lesions was heterogeneous. The rCBV of the periphery of the lesions was higher than that at their center. There was a correlation between the time since onset and abnormalities on the rCBV map and T2-weighted images (T2WI). In the early stage of acute stroke, the abnormalities tended to be larger on the rCBV than on T2WI. Many patterns of bolus passage were observed in ischaemic regions. rCBV maps provide additional haemodynamic information in patients with brain infarcts.

Systematic Review of Diffusion and Perfusion Imaging in Acute Ischemic Stroke

“…All studies used the gadolinium bolus tracking method of measuring blood transit time. A variety of perfusion abnormalities were demonstrated; 1 study 56 (nϭ11) noted a heterogeneous distribution of rCBF in the expected regions of interest in all examinations; 3 6,7,55 (nϭ16 to nϭ34) documented hyperperfusion as well as delayed or absent perfusion in the region of interest; and 1 54 (nϭ11) documented no perfusion deficits in 4 of the 11 subjects despite marked clinical signs and repeat MR within 48 hours confirming infarction.…”

Arterial cerebral blood volume-weighted functional MRI using pseudocontinuous arterial spin tagging (AVAST)

“…Cerebral blood volume (CBV) is a very important measurement for the study of a number of neurological disorders that involve vascular dysregulation. These include hypertension, stroke , small brain infarcts , Alzheimer disease , astrocytoma and other brain tumors , and cerebral stenoses . The ability to separate the arterial compartment from the venous compartment of CBV may provide additional information not obtainable by imaging the total CBV [e.g., in steno‐occlusive disease of the internal carotid artery ].…”

On the measurement of absolute cerebral blood volume (CBV) using vascular‐space‐occupancy (VASO) MRI

“…Quantitative measurement of cerebral blood volume (CBV, defined as ml blood in 100 ml brain) is useful for advancing our understanding of brain physiology and pathophysiology (1, 2). It has been reported that many brain disorders, including stroke (1, 3, 4) and Alzheimer's disease (5–8), are associated with abnormal CBV. Compared to cerebral blood flow (CBF), CBV has been less extensively studied, but it was recently shown to be particularly sensitive to brain tumor grade (9), and it may be a useful marker for angiogenesis and synaptogenesis (10, 11).…”