Regional Ischemia and Ischemic Injury in Patients With Acute Middle Cerebral Artery Stroke as Defined by Early Diffusion-Weighted and Perfusion-Weighted MRI

Rordorf, Guy; Wj, Koroshetz; Wa, Copen; Cramer, SC; Pw, Schaefer; Rf, Budzik; Schwamm, Lee H.; Buonanno, Ferdinando S.; Ag, Sorensen; González, Gilberto

doi:10.1161/01.str.29.5.939

Cited by 228 publications

(133 citation statements)

References 13 publications

(24 reference statements)

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“…It seems obvious that the decrease in CBF corresponds to those observed in laser Doppler flowmetry, positron emission tomography, and perfusion-weighted magnetic resonance imaging studies of stroke. 13,[32][33][34][35][36] The persistent reduction in neuronal IM might be related with decreases in the cerebral metabolic rate for oxygen and glucose measured by positron emission tomography in stroke patients. [33][34][35] Also, the reduced IM is of immediate relevance in quantifying the nature of changes in cellular dynamics revealed by diffusion-weighted magnetic resonance imaging in human studies of stroke.…”

Section: Discussionmentioning

confidence: 99%

Quantitative Imaging of Cerebral Blood Flow Velocity and Intracellular Motility using Dynamic Light Scattering–Optical Coherence Tomography

Lee

Radhakrishnan

et al. 2013

J Cereb Blood Flow Metab

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This paper describes a novel optical method for label-free quantitative imaging of cerebral blood flow (CBF) and intracellular motility (IM) in the rodent cerebral cortex. This method is based on a technique that integrates dynamic light scattering (DLS) and optical coherence tomography (OCT), named DLS-OCT. The technique measures both the axial and transverse velocities of CBF, whereas conventional Doppler OCT measures only the axial one. In addition, the technique produces a three-dimensional map of the diffusion coefficient quantifying nontranslational motions. In the DLS-OCT diffusion map, we observed high-diffusion spots, whose locations highly correspond to neuronal cell bodies and whose diffusion coefficient agreed with that of the motion of intracellular organelles reported in vitro in the literature. Therefore, the present method has enabled, for the first time to our knowledge, label-free imaging of the diffusion-like motion of intracellular organelles in vivo. As an example application, we used the method to monitor CBF and IM during a brief ischemic stroke, where we observed an induced persistent reduction in IM despite the recovery of CBF after stroke. This result supports that the IM measured in this study represent the cellular energy metabolism-related active motion of intracellular organelles rather than free diffusion of intracellular macromolecules.

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Section: Discussionmentioning

confidence: 99%

Quantitative Imaging of Cerebral Blood Flow Velocity and Intracellular Motility using Dynamic Light Scattering–Optical Coherence Tomography

Lee

Radhakrishnan

et al. 2013

J Cereb Blood Flow Metab

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“…PWI and DWI allow actual ischemic lesions to be delineated with a relatively high sensitivity and specificity (1)(2)(3)(4)(5)(6)(7). In acute ischemic brain tissue DWI can detect decreased movement of water protons due to cytotoxic edema, which results in a decrease of the apparent diffusion coefficient (ADC) of water and an increase in the signal intensity.…”

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confidence: 99%

Significance of the perfusion‐diffusion mismatch in chronic cerebral ischemia

Surikova

Meisel

Siebler

et al. 2006

Magnetic Resonance Imaging

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Purpose: To determine whether the perfusion deficit could predict brain infarction in patients with chronic cerebral ischemia who experienced recurring episodes of neurological symptoms and showed a perfusion-diffusion mismatch on magnetic resonance (MR) images. Materials and Methods:In 53 consecutive patients (38 males and 15 females, 62 Ϯ 13 years old) with ischemia in the middle cerebral artery (MCA) territory, lesion volumetry was performed on parametric maps of the time-to-peak, the cerebral blood volume, and diffusion-weighted (DW) images. The infarct lesions were assessed on follow-up T2-weighted (T2W) MR images after eight days. Cerebrovascular changes were determined by time-of-flight (TOF) MR angiography (MRA). Inferential and correlation statistics were used. Results:Patients with chronic ischemic brain disease (N ϭ 39) who presented with a severe perfusion-diffusion mismatch in the presence of a normal cerebral blood volume had no or small brain infarctions as found on follow-up T2W images. MRA revealed widespread abnormalities of the basal cerebral arteries compatible with brain perfusion abnormalities. In contrast, in acute stroke patients (N ϭ 14) the deficit of cerebral perfusion predicted the infarct lesion in the T2W images. Conclusion:Our results suggest that in chronic cerebral ischemia the normal blood volume was maintained despite the depression of cerebral perfusion and recurring minor insults.

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“…1,17) MR imaging may not show lesions in which the degree of the ischemic damage is not so severe as to affect the MR relaxation parameters. 11,23,24,29) The present study measured the FA value in patients with symptomatic unilateral major cerebral artery occlusive disease to compare the FA values before and after vascular reconstruction surgery to confirm whether DT imaging can detect brain ischemia not visualized by conventional MR imaging.…”

Section: Introductionmentioning

confidence: 94%

Diffusion Tensor Imaging in Patients With Major Cerebral Artery Occlusive Disease

Inoue

Ogasawara

Konno

et al. 2003

Neurol. Med. Chir.(Tokyo)

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Diffusion tensor (DT) imaging provides quantitative information about the magnitude and the directionality (anisotropy) of water diffusion in vivo and can detect pathologic changes in brain ischemia. This study tried to detect ischemic brain damage using DT imaging in patients with symptomatic chronic major cerebral artery occlusive disease. DT imaging was performed using a 3.0 Tesla magnetic resonance (MR) scanner in 50 patients with unilateral internal carotid artery or middle cerebral artery stenosis or occlusion, who had no obvious infarct lesions on conventional MR imaging. Thirty-three patients underwent DT imaging before and after vascular reconstruction surgery. Fractional anisotropy (FA) was calculated in the middle cerebral artery territory. Preoperative FA values in the ipsilateral side were significantly lower than those in the contralateral side. After surgery, the FA value was significantly increased. DT imaging may indicate ischemic brain damage, not visualized by conventional MR imaging, in patients with major cerebral artery occlusive disease.

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Regional Ischemia and Ischemic Injury in Patients With Acute Middle Cerebral Artery Stroke as Defined by Early Diffusion-Weighted and Perfusion-Weighted MRI

Cited by 228 publications

References 13 publications

Quantitative Imaging of Cerebral Blood Flow Velocity and Intracellular Motility using Dynamic Light Scattering–Optical Coherence Tomography

Quantitative Imaging of Cerebral Blood Flow Velocity and Intracellular Motility using Dynamic Light Scattering–Optical Coherence Tomography

Significance of the perfusion‐diffusion mismatch in chronic cerebral ischemia

Diffusion Tensor Imaging in Patients With Major Cerebral Artery Occlusive Disease

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