Perfusion-weighted imaging and dynamic 4D angiograms for the estimation of collateral blood flow in lacunar infarction

Förster, Alex; Mürle, Bettina; Böhme, Johannes; Al-Zghloul, Mansour; Kerl, H; Wenz, Holger; Groden, Christoph

doi:10.1177/0271678x15606458

Cited by 20 publications

(27 citation statements)

References 40 publications

(61 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…It is well known that LI is the most important small vessel cerebrovascular disease, accounting for 20%–25% of all ischemic strokes. 6 , 28 LI has been involved in the two major vascular pathologies with small size penetrating brain arteries and arterioles: thickening of the arterial media and obstruction of penetrating arteries. 1 , 29 Considering that the prevalence of LI increases with age before 60 years and decreases with age after 69 years in the elderly, we inferred the pathogenesis of LI that age around 60 years is a fragile and vulnerable period to be easy to induce the small vascular pathologies and the occurrence of LI.…”

Section: Discussionmentioning

confidence: 99%

The prevalence of lacunar infarct decreases with aging in the elderly: a case-controlled analysis

Zhang

Peng

et al. 2016

CIA

View full text Add to dashboard Cite

Background and purposeLacunar infarct (LI) is well known as a heterogeneous primary disorder of cerebral small vessel. Compelling results have demonstrated that age is a risk factor to the prevalence of LI. However, the relationship between age and the prevalence of LI remains obscure. It is essential to note the relationship between age and the prevalence of LI through more clinical data.MethodsA total of 3,500 patients were included in the case-controlled study. All data were collected from the Examination Center of Magnetic Resonance Imaging, Lu’an People’s Hospital from January 2014 to December 2015. A primary discharge diagnosis of LI was done, and all subjects were evaluated as retrospective data. The relationship between the risk factors and the prevalence of diabetes and the relationship between age and the prevalence of diabetes was analyzed. A chi-square test was used to analyze the associations between different variables. A one-way analysis of variance was used to test the equality of three or more means at one time by using variances. Statistical significance was defined as a P-value of <0.05.ResultsThe one-way analysis of variance demonstrated that the prevalence of LI increased with age before 60 years and decreased with age after 69 years. The same results were found in both the male and the female subjects. These results showed that the age-related risk factors (hypertension, diabetes, cerebral infarct, cardiovascular diseases, smoking, and drinking) have no relationship with the prevalence of LI on the basis of age. There is a significant difference among the different age ranges (P=0.0006). Two-tailed P-value (unpaired t-test) showed the mean significant difference between 30–39 years and 40–49 years (P=0.009) and between 70–79 years and 80–100 years (P=0.0196). F-test (to compare variances) demonstrated that the variances of the different age ranges are significantly different between 30–39 years and 40–49 years (P=0.0002), between 40–49 years and 50–59 years (P=0.0424), and between 70–79 years and 80–100 years (P=0.0003).ConclusionThe age-related risk factors (hypertension, diabetes, cerebral infarct, cardiovascular diseases, smoking, and drinking) have no relationship with the prevalence of LI on the basis of age. A decreasing prevalence of LI with aging occurs in the elderly, while the prevalence of LI increases with aging in the young and in adults. This investigation implicates that age is not a risk factor for LI in the elderly.

show abstract

Section: Discussionmentioning

confidence: 99%

The prevalence of lacunar infarct decreases with aging in the elderly: a case-controlled analysis

Zhang

Peng

et al. 2016

CIA

View full text Add to dashboard Cite

show abstract

“…DSA, an invasive imaging method, is the gold standard for the diagnosis of intracranial venous diseases. Currently, various advanced imaging techniques are available, using either non-enhanced or contrast-enhanced methods (Forster et al, 2016). Here we briefly describe their characteristics and possible applications (Table 1).…”

Section: Venous Visualization By Varied Image Modalitiesmentioning

confidence: 99%

Cerebral venous collaterals: A new fort for fighting ischemic stroke?

Tong

Guo

et al. 2018

Progress in Neurobiology

View full text Add to dashboard Cite

Stroke therapy has entered a new era highlighted by the use of endovascular therapy in addition to intravenous thrombolysis. However, the efficacy of current therapeutic regimens might be reduced by their associated adverse events. For example, over-reperfusion and futile recanalization may lead to large infarct, brain swelling, hemorrhagic complication and neurological deterioration. The traditional pathophysiological understanding on ischemic stroke can hardly address these occurrences. Accumulating evidence suggests that a functional cerebral venous drainage, the major blood reservoir and drainage system in brain, may be as critical as arterial infusion for stroke evolution and clinical sequelae. Further exploration of the multi-faceted function of cerebral venous system may add new implications for stroke outcome prediction and future therapeutic decision-making. In this review, we emphasize the anatomical and functional characteristics of the cerebral venous system and illustrate its necessity in facilitating the arterial infusion and maintaining the cerebral perfusion in the pathological stroke content. We then summarize the recent critical clinical studies that underscore the associations between cerebral venous collateral and outcome of ischemic stroke with advanced imaging techniques. A novel three-level venous system classification is proposed to demonstrate the distinct characteristics of venous collaterals in the setting of ischemic stroke. Finally, we discuss the current directions for assessment of cerebral venous collaterals and provide future challenges and opportunities for therapeutic strategies in the light of these new concepts.

show abstract

“…Thus, a recent series of patients with acute lacunar infarcts studied using dynamic angiograms generated by perfusion weighted raw images identified the presence of assorted perfusion patterns including some that could be attributed to collateral blood flow. 17 However, other possible compensatory mechanisms were not assessed because only patients with hypoperfusion in the perfusion-weighted imaging were studied. Especially in patients with RSSIs that do not show hypoperfusion, pre-occluded perforating arteries may have recanalized and thus perfusion may have been restored.…”

Section: Introductionmentioning

confidence: 99%

Cerebral perfusion and compensatory blood supply in patients with recent small subcortical infarcts

Rudilosso

Laredo

Mancosu³

et al. 2018

J Cereb Blood Flow Metab

View full text Add to dashboard Cite

Hypoperfusion is the typical perfusion pattern associated with recent small subcortical infarcts of the brain, but other perfusion patterns may be present in patients with these infarcts. Using CT perfusion, we studied 67 consecutive patients who had a small subcortical infarct at a follow-up MRI study to investigate the correlation between the perfusion pattern and the clinical and radiological course. On CT perfusion map analysis, 51 patients (76%) had focal hypoperfusion, 4 patients (6%) had hyperperfusion and the remaining 12 patients (18%) showed no abnormalities. On dynamic sequential imaging analysis obtained from the source perfusion images, 32 patients (48%) had a sustained hypoperfusion pattern, 11 patients (16%) had a reperfusion pattern, and 18 patients (27%) had a delayed compensation pattern. Systolic blood pressure was higher in patients with sustained hypoperfusion although the perfusion pattern was independent of the final volume of infarction. These results reinforce the notion that mechanisms other than hypoperfusion are at play in patients with small subcortical infarcts including the intervention of compensatory sources of blood flow. The ultimate clinical significance of these perfusion patterns remains to be determined in larger series of patients assessed longitudinally.

show abstract

Perfusion-weighted imaging and dynamic 4D angiograms for the estimation of collateral blood flow in lacunar infarction

Cited by 20 publications

References 40 publications

The prevalence of lacunar infarct decreases with aging in the elderly: a case-controlled analysis

The prevalence of lacunar infarct decreases with aging in the elderly: a case-controlled analysis

Cerebral venous collaterals: A new fort for fighting ischemic stroke?

Cerebral perfusion and compensatory blood supply in patients with recent small subcortical infarcts

Contact Info

Product

Resources

About