Magnetic resonance perfusion imaging in acute ischemic Stroke using continuous arterial spin labeling
Continuous arterial spin-labeled perfusion MRI (CASL-PI) uses electromagnetically labeled arterial blood water as a diffusible tracer to noninvasively measure cerebral blood flow (CBF). We hypothesized that CASL-PI could detect perfusion deficits and perfusion/diffusion mismatches and predict outcom...
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| Veröffentlicht in: | Stroke (1970) 2000-03, Vol.31 (3), p.680-687 |
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| container_title | Stroke (1970) |
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| creator | CHALELA, J. A ALSOP, D. C GONZALEZ-ATAVALES, J. B MALDJIAN, J. A KASNER, S. E DETRE, J. A |
| description | Continuous arterial spin-labeled perfusion MRI (CASL-PI) uses electromagnetically labeled arterial blood water as a diffusible tracer to noninvasively measure cerebral blood flow (CBF). We hypothesized that CASL-PI could detect perfusion deficits and perfusion/diffusion mismatches and predict outcome in acute ischemic stroke.
We studied 15 patients with acute ischemic stroke within 24 hours of symptom onset. With the use of a 6-minute imaging protocol, CASL-PI was measured at 1.5 T in 8-mm contiguous supratentorial slices with a 3.75-mm in-plane resolution. Diffusion-weighted images were also obtained. Visual inspection for perfusion deficits, perfusion/diffusion mismatches, and effects of delayed arterial transit was performed. CBF in predetermined vascular territories was quantified by transformation into Talairach space. Regional CBF values were correlated with National Institutes of Health Stroke Scale (NIHSS) score on admission and Rankin Scale (RS) score at 30 days.
Interpretable CASL-PI images were obtained in all patients. Perfusion deficits were consistent with symptoms and/or diffusion-weighted imaging abnormalities. Eleven patients had hypoperfusion, 3 had normal perfusion, and 1 had relative hyperperfusion. Perfusion/diffusion mismatches were present in 8 patients. Delayed arterial transit effect was present in 7 patients; serial imaging in 2 of them showed that the delayed arterial transit area did not succumb to infarction. CBF in the affected hemisphere correlated with NIHSS and RS scores (P=0.037 and P=0.003, Spearman rank correlation). The interhemispheric percent difference in middle cerebral artery CBF correlated with NIHSS and RS scores (P=0.007 and P=0.0002, respectively).
CASL-PI provides rapid noninvasive multislice imaging in acute ischemic stroke. It depicts perfusion deficits and perfusion/diffusion mismatches and quantifies regional CBF. CASL-PI CBF asymmetries correlate with severity and outcome. Delayed arterial transit effects may indicate collateral flow. |
| doi_str_mv | 10.1161/01.str.31.3.680 |
| format | Article |
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We studied 15 patients with acute ischemic stroke within 24 hours of symptom onset. With the use of a 6-minute imaging protocol, CASL-PI was measured at 1.5 T in 8-mm contiguous supratentorial slices with a 3.75-mm in-plane resolution. Diffusion-weighted images were also obtained. Visual inspection for perfusion deficits, perfusion/diffusion mismatches, and effects of delayed arterial transit was performed. CBF in predetermined vascular territories was quantified by transformation into Talairach space. Regional CBF values were correlated with National Institutes of Health Stroke Scale (NIHSS) score on admission and Rankin Scale (RS) score at 30 days.
Interpretable CASL-PI images were obtained in all patients. Perfusion deficits were consistent with symptoms and/or diffusion-weighted imaging abnormalities. Eleven patients had hypoperfusion, 3 had normal perfusion, and 1 had relative hyperperfusion. Perfusion/diffusion mismatches were present in 8 patients. Delayed arterial transit effect was present in 7 patients; serial imaging in 2 of them showed that the delayed arterial transit area did not succumb to infarction. CBF in the affected hemisphere correlated with NIHSS and RS scores (P=0.037 and P=0.003, Spearman rank correlation). The interhemispheric percent difference in middle cerebral artery CBF correlated with NIHSS and RS scores (P=0.007 and P=0.0002, respectively).
CASL-PI provides rapid noninvasive multislice imaging in acute ischemic stroke. It depicts perfusion deficits and perfusion/diffusion mismatches and quantifies regional CBF. CASL-PI CBF asymmetries correlate with severity and outcome. Delayed arterial transit effects may indicate collateral flow.</description><identifier>ISSN: 0039-2499</identifier><identifier>EISSN: 1524-4628</identifier><identifier>DOI: 10.1161/01.str.31.3.680</identifier><identifier>PMID: 10700504</identifier><identifier>CODEN: SJCCA7</identifier><language>eng</language><publisher>Hagerstown, MD: Lippincott Williams & Wilkins</publisher><subject>Acute Disease ; Adult ; Aged ; Arteries ; Biological and medical sciences ; Brain Ischemia - diagnosis ; Brain Ischemia - physiopathology ; Cerebrovascular Circulation ; Diffusion ; Female ; Humans ; Magnetic Resonance Imaging - methods ; Male ; Medical sciences ; Middle Aged ; Neurology ; Severity of Illness Index ; Spin Labels ; Stroke - diagnosis ; Stroke - physiopathology ; Vascular diseases and vascular malformations of the nervous system</subject><ispartof>Stroke (1970), 2000-03, Vol.31 (3), p.680-687</ispartof><rights>2000 INIST-CNRS</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c510t-9a6c49f832163391305c7786c1056d9d93a422c7d10e9cdc11fdec7c2b3ec5833</citedby><cites>FETCH-LOGICAL-c510t-9a6c49f832163391305c7786c1056d9d93a422c7d10e9cdc11fdec7c2b3ec5833</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,3674,27901,27902</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=1289539$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/10700504$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>CHALELA, J. A</creatorcontrib><creatorcontrib>ALSOP, D. C</creatorcontrib><creatorcontrib>GONZALEZ-ATAVALES, J. B</creatorcontrib><creatorcontrib>MALDJIAN, J. A</creatorcontrib><creatorcontrib>KASNER, S. E</creatorcontrib><creatorcontrib>DETRE, J. A</creatorcontrib><title>Magnetic resonance perfusion imaging in acute ischemic Stroke using continuous arterial spin labeling</title><title>Stroke (1970)</title><addtitle>Stroke</addtitle><description>Continuous arterial spin-labeled perfusion MRI (CASL-PI) uses electromagnetically labeled arterial blood water as a diffusible tracer to noninvasively measure cerebral blood flow (CBF). We hypothesized that CASL-PI could detect perfusion deficits and perfusion/diffusion mismatches and predict outcome in acute ischemic stroke.
We studied 15 patients with acute ischemic stroke within 24 hours of symptom onset. With the use of a 6-minute imaging protocol, CASL-PI was measured at 1.5 T in 8-mm contiguous supratentorial slices with a 3.75-mm in-plane resolution. Diffusion-weighted images were also obtained. Visual inspection for perfusion deficits, perfusion/diffusion mismatches, and effects of delayed arterial transit was performed. CBF in predetermined vascular territories was quantified by transformation into Talairach space. Regional CBF values were correlated with National Institutes of Health Stroke Scale (NIHSS) score on admission and Rankin Scale (RS) score at 30 days.
Interpretable CASL-PI images were obtained in all patients. Perfusion deficits were consistent with symptoms and/or diffusion-weighted imaging abnormalities. Eleven patients had hypoperfusion, 3 had normal perfusion, and 1 had relative hyperperfusion. Perfusion/diffusion mismatches were present in 8 patients. Delayed arterial transit effect was present in 7 patients; serial imaging in 2 of them showed that the delayed arterial transit area did not succumb to infarction. CBF in the affected hemisphere correlated with NIHSS and RS scores (P=0.037 and P=0.003, Spearman rank correlation). The interhemispheric percent difference in middle cerebral artery CBF correlated with NIHSS and RS scores (P=0.007 and P=0.0002, respectively).
CASL-PI provides rapid noninvasive multislice imaging in acute ischemic stroke. It depicts perfusion deficits and perfusion/diffusion mismatches and quantifies regional CBF. CASL-PI CBF asymmetries correlate with severity and outcome. Delayed arterial transit effects may indicate collateral flow.</description><subject>Acute Disease</subject><subject>Adult</subject><subject>Aged</subject><subject>Arteries</subject><subject>Biological and medical sciences</subject><subject>Brain Ischemia - diagnosis</subject><subject>Brain Ischemia - physiopathology</subject><subject>Cerebrovascular Circulation</subject><subject>Diffusion</subject><subject>Female</subject><subject>Humans</subject><subject>Magnetic Resonance Imaging - methods</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Neurology</subject><subject>Severity of Illness Index</subject><subject>Spin Labels</subject><subject>Stroke - diagnosis</subject><subject>Stroke - physiopathology</subject><subject>Vascular diseases and vascular malformations of the nervous system</subject><issn>0039-2499</issn><issn>1524-4628</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2000</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpN0E1PHDEMBuCoApUt9NwbygFxm8FO5ivHCgGtBELi4xxlPZ5tYDazJDOH_vum2pXakw9-bNmvEN8QSsQGrwDLNMdSY6nLpoNPYoW1qoqqUd2RWAFoU6jKmBPxJaU3AFC6qz-LE4QWoIZqJfjBbQLPnmTkNAUXiOWO47AkPwXpt27jw0b6IB0tM0uf6Bdvs36e4_TOMrPcpinMPizTkqSLM0fvRpl2eWh0ax6zOBPHgxsTfz3UU_F6e_Ny_aO4f7z7ef39vqAaYS6Ma6gyQ6cVNlob1FBT23YNIdRNb3qjXaUUtT0CG-oJceiZWlJrzVR3Wp-Ky_3eXZw-Fk6z3eaLeRxd4HydbcFUAFhleLWHFKeUIg92F_Oz8bdFsH-TtYD2-eXJarTa5mTzxPlh9bLecv-f30eZwcUBuERuHGLO0qd_TnWm1kb_AfQrgl8</recordid><startdate>20000301</startdate><enddate>20000301</enddate><creator>CHALELA, J. A</creator><creator>ALSOP, D. C</creator><creator>GONZALEZ-ATAVALES, J. B</creator><creator>MALDJIAN, J. A</creator><creator>KASNER, S. E</creator><creator>DETRE, J. A</creator><general>Lippincott Williams & Wilkins</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20000301</creationdate><title>Magnetic resonance perfusion imaging in acute ischemic Stroke using continuous arterial spin labeling</title><author>CHALELA, J. A ; ALSOP, D. C ; GONZALEZ-ATAVALES, J. B ; MALDJIAN, J. A ; KASNER, S. E ; DETRE, J. A</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c510t-9a6c49f832163391305c7786c1056d9d93a422c7d10e9cdc11fdec7c2b3ec5833</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2000</creationdate><topic>Acute Disease</topic><topic>Adult</topic><topic>Aged</topic><topic>Arteries</topic><topic>Biological and medical sciences</topic><topic>Brain Ischemia - diagnosis</topic><topic>Brain Ischemia - physiopathology</topic><topic>Cerebrovascular Circulation</topic><topic>Diffusion</topic><topic>Female</topic><topic>Humans</topic><topic>Magnetic Resonance Imaging - methods</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Neurology</topic><topic>Severity of Illness Index</topic><topic>Spin Labels</topic><topic>Stroke - diagnosis</topic><topic>Stroke - physiopathology</topic><topic>Vascular diseases and vascular malformations of the nervous system</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>CHALELA, J. A</creatorcontrib><creatorcontrib>ALSOP, D. C</creatorcontrib><creatorcontrib>GONZALEZ-ATAVALES, J. B</creatorcontrib><creatorcontrib>MALDJIAN, J. A</creatorcontrib><creatorcontrib>KASNER, S. E</creatorcontrib><creatorcontrib>DETRE, J. A</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Stroke (1970)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>CHALELA, J. A</au><au>ALSOP, D. C</au><au>GONZALEZ-ATAVALES, J. B</au><au>MALDJIAN, J. A</au><au>KASNER, S. E</au><au>DETRE, J. A</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Magnetic resonance perfusion imaging in acute ischemic Stroke using continuous arterial spin labeling</atitle><jtitle>Stroke (1970)</jtitle><addtitle>Stroke</addtitle><date>2000-03-01</date><risdate>2000</risdate><volume>31</volume><issue>3</issue><spage>680</spage><epage>687</epage><pages>680-687</pages><issn>0039-2499</issn><eissn>1524-4628</eissn><coden>SJCCA7</coden><abstract>Continuous arterial spin-labeled perfusion MRI (CASL-PI) uses electromagnetically labeled arterial blood water as a diffusible tracer to noninvasively measure cerebral blood flow (CBF). We hypothesized that CASL-PI could detect perfusion deficits and perfusion/diffusion mismatches and predict outcome in acute ischemic stroke.
We studied 15 patients with acute ischemic stroke within 24 hours of symptom onset. With the use of a 6-minute imaging protocol, CASL-PI was measured at 1.5 T in 8-mm contiguous supratentorial slices with a 3.75-mm in-plane resolution. Diffusion-weighted images were also obtained. Visual inspection for perfusion deficits, perfusion/diffusion mismatches, and effects of delayed arterial transit was performed. CBF in predetermined vascular territories was quantified by transformation into Talairach space. Regional CBF values were correlated with National Institutes of Health Stroke Scale (NIHSS) score on admission and Rankin Scale (RS) score at 30 days.
Interpretable CASL-PI images were obtained in all patients. Perfusion deficits were consistent with symptoms and/or diffusion-weighted imaging abnormalities. Eleven patients had hypoperfusion, 3 had normal perfusion, and 1 had relative hyperperfusion. Perfusion/diffusion mismatches were present in 8 patients. Delayed arterial transit effect was present in 7 patients; serial imaging in 2 of them showed that the delayed arterial transit area did not succumb to infarction. CBF in the affected hemisphere correlated with NIHSS and RS scores (P=0.037 and P=0.003, Spearman rank correlation). The interhemispheric percent difference in middle cerebral artery CBF correlated with NIHSS and RS scores (P=0.007 and P=0.0002, respectively).
CASL-PI provides rapid noninvasive multislice imaging in acute ischemic stroke. It depicts perfusion deficits and perfusion/diffusion mismatches and quantifies regional CBF. CASL-PI CBF asymmetries correlate with severity and outcome. Delayed arterial transit effects may indicate collateral flow.</abstract><cop>Hagerstown, MD</cop><pub>Lippincott Williams & Wilkins</pub><pmid>10700504</pmid><doi>10.1161/01.str.31.3.680</doi><tpages>8</tpages><oa>free_for_read</oa></addata></record> |
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| ispartof | Stroke (1970), 2000-03, Vol.31 (3), p.680-687 |
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| source | MEDLINE; American Heart Association Journals; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; Alma/SFX Local Collection; Journals@Ovid Complete |
| subjects | Acute Disease Adult Aged Arteries Biological and medical sciences Brain Ischemia - diagnosis Brain Ischemia - physiopathology Cerebrovascular Circulation Diffusion Female Humans Magnetic Resonance Imaging - methods Male Medical sciences Middle Aged Neurology Severity of Illness Index Spin Labels Stroke - diagnosis Stroke - physiopathology Vascular diseases and vascular malformations of the nervous system |
| title | Magnetic resonance perfusion imaging in acute ischemic Stroke using continuous arterial spin labeling |
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