Quantification of Serial Cerebral Blood Flow in Acute Stroke Using Arterial Spin Labeling

Stroke - Tập 48 Số 1 - Trang 123-130 - 2017
George Harston1,2,3,4, Thomas W. Okell1,3,4,5, Fintan Sheerin6,1,3,4, Ursula G. Schulz1,3,4,7, P Mathieson1,3,4,8, Ian Reckless1,9,3,4, Kunal Shah1,3,10,4, Gary A. Ford1,11,3,4, Michael A. Chappell1,3,12,4, Peter Jezzard1,3,4,13, James Kennedy1,3,14,4
1From the Acute Vascular Imaging Centre, Radcliffe Department of Medicine, University of Oxford, United Kingdom (G.W.J.H., J.K.); Oxford Centre for Functional MRI of the Brain, Nuffield Department of Clinical Neurosciences, University of Oxford, United Kingdom (T.W.O., M.A.C., P.J.); Department of Neuroradiology (F.S.) and Acute Stroke Service (U.S., P.M., I.R., K.S., G.A.F., J.K.), Oxford University Hospitals NHS Foundation Trust, United Kingdom; Institute of Biomedical Engineering, Department of...
2George W.J. Harston From the Acute Vascular Imaging Centre, Radcliffe Department of Medicine, University of Oxford, United Kingdom (G.W.J.H., J.K.)
3Institute of Biomedical Engineering, Department of Engineering Science, University of Oxford, United Kingdom (M.A.C.).
4Oxford Centre for Functional MRI of the Brain, Nuffield Department of Clinical Neurosciences, University of Oxford, United Kingdom (T.W.O., M.A.C., P.J.)
5Thomas W. Okell From the Acute Vascular Imaging Centre, Radcliffe Department of Medicine, University of Oxford, United Kingdom (G.W.J.H., J.K.)
6Fintan Sheerin From the Acute Vascular Imaging Centre, Radcliffe Department of Medicine, University of Oxford, United Kingdom (G.W.J.H., J.K.)
7Ursula Schulz From the Acute Vascular Imaging Centre, Radcliffe Department of Medicine, University of Oxford, United Kingdom (G.W.J.H., J.K.)
8Phil Mathieson From the Acute Vascular Imaging Centre, Radcliffe Department of Medicine, University of Oxford, United Kingdom (G.W.J.H., J.K.)
9Ian Reckless From the Acute Vascular Imaging Centre, Radcliffe Department of Medicine, University of Oxford, United Kingdom (G.W.J.H., J.K.)
10Kunal Shah From the Acute Vascular Imaging Centre, Radcliffe Department of Medicine, University of Oxford, United Kingdom (G.W.J.H., J.K.)
11Gary A. Ford From the Acute Vascular Imaging Centre, Radcliffe Department of Medicine, University of Oxford, United Kingdom (G.W.J.H., J.K.)
12Michael A. Chappell From the Acute Vascular Imaging Centre, Radcliffe Department of Medicine, University of Oxford, United Kingdom (G.W.J.H., J.K.)
13Peter Jezzard From the Acute Vascular Imaging Centre, Radcliffe Department of Medicine, University of Oxford, United Kingdom (G.W.J.H., J.K.)
14James Kennedy From the Acute Vascular Imaging Centre, Radcliffe Department of Medicine, University of Oxford, United Kingdom (G.W.J.H., J.K.)

Tóm tắt

Background and Purpose— Perfusion-weighted imaging is used to select patients with acute ischemic stroke for intervention, but knowledge of cerebral perfusion can also inform the understanding of ischemic injury. Arterial spin labeling allows repeated measurement of absolute cerebral blood flow (CBF) without the need for exogenous contrast. The aim of this study was to explore the relationship between dynamic CBF and tissue outcome in the month after stroke onset. Methods— Patients with nonlacunar ischemic stroke underwent ≤5 repeated magnetic resonance imaging scans at presentation, 2 hours, 1 day, 1 week, and 1 month. Imaging included vessel-encoded pseudocontinuous arterial spin labeling using multiple postlabeling delays to quantify CBF in gray matter regions of interest. Receiver–operator characteristic curves were used to predict tissue outcome using CBF. Repeatability was assessed in 6 healthy volunteers and compared with contralateral regions of patients. Diffusion-weighted and T2-weighted fluid attenuated inversion recovery imaging were used to define tissue outcome. Results— Forty patients were included. In contralateral regions of patients, there was significant variation of CBF between individuals, but not between scan times (mean±SD: 53±42 mL/100 g/min). Within ischemic regions, mean CBF was lowest in ischemic core (17±23 mL/100 g/min), followed by regions of early (21±26 mL/100 g/min) and late infarct growth (25±35 mL/100 g/min; ANOVA P <0.0001). Between patients, there was marked overlap in presenting and serial CBF values. Conclusions— Knowledge of perfusion dynamics partially explained tissue fate. Factors such as metabolism and tissue susceptibility are also likely to influence tissue outcome.

Từ khóa


Tài liệu tham khảo

10.3174/ajnr.A4208

10.1161/STROKEAHA.107.512319

10.1161/STROKEAHA.108.526954

10.1016/S1474-4422(12)70203-X

10.1212/01.wnl.0000345372.49233.e3

10.1002/jmri.22338

10.1161/STROKEAHA.110.580670

10.1002/mrm.1910400308

10.1161/STROKEAHA.113.003612

10.1016/j.nicl.2013.06.017

10.1038/jcbfm.2013.129

10.1002/ana.24528

10.1002/mrm.22524

10.1006/nimg.2002.1132

10.1016/j.neuroimage.2011.09.015

10.1016/j.media.2011.12.004

10.1109/TSP.2008.2005752

10.1016/j.neuroimage.2006.01.021

10.1111/ijs.12068

10.1161/STROKEAHA.113.002015

10.1109/42.906424

10.1002/1097-0142(1950)3:1<32::AID-CNCR2820030106>3.0.CO;2-3

10.1097/00004728-198012000-00001

10.1097/00004647-200008000-00010

10.1093/brain/113.1.27

10.1161/01.STR.15.4.635

10.1161/hs0102.100884

10.1212/WNL.52.9.1792

10.1016/0022-510X(77)90014-4

10.1161/STROKEAHA.108.546069

10.1002/ana.22500

10.1161/01.STR.22.8.1032

10.1002/ana.410140307

10.1038/nrn1927

10.1016/S0166-2236(99)01401-0

10.1016/S1474-4422(12)70234-X

10.1161/STROKEAHA.106.477109

10.1001/archneur.1989.00520480077023

10.1161/01.STR.17.5.853

10.1038/jcbfm.2014.163

10.1038/jcbfm.2011.10

10.1097/00001756-200106130-00011

10.1002/ana.10380

10.1038/nm.2507

Thông tin
Thông tin xuất bản

Stroke

Tập 48 Số 1

123-130

Thông tin tác giả