Arterial spin labeling and dynamic susceptibility contrast CBF MRI in postischemic hyperperfusion, hypercapnia, and after mannitol injection

Tanaka, Yoji; Nagaoka, Tsukasa; Nair, Govind; Ohno, Kikuo; Duong, Timothy Q.

doi:10.1038/jcbfm.2010.228

Cited by 47 publications

(55 citation statements)

References 43 publications

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“…32,33 The presence of hyperperfusion after stroke on ASL indicated reperfusion and collateralization, correlating with stroke severity and functional outcome. By contrast, Tanaka's team 34 reported longer T 1 values in the ischemic area and freer extavasation of water in the blood by disruption of the blood-brain barrier, which resulted in overestimation of CBF by ASL as hyperperfusion.…”

Section: Discussionmentioning

confidence: 94%

Operator-bias-free Comparison of Quantitative Perfusion Maps Acquired with Pulsed-continuous Arterial Spin Labeling and Single-photon-emission Computed Tomography

Iwanaga

Harada

Kubo

et al. 2014

MRMS

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Purpose: We compared the regional cerebral blood flow (rCBF) obtained by pulsed continuous arterial spin labeling (pCASL) and iodine-123-N-isopropyl-p-iodoamphetamine (IMP) single photon emission computed tomography (SPECT) using 3-dimensional stereotactic region-of-interest (ROI) software for automated definition of ROIs in anatomic regions of the brain.Methods: Thirteen patients with cerebrovascular occlusive disease and three with transient ischemic attacks underwent pCASL and IMP SPECT imaging. We compared rCBF values of each anatomic region and calculated the correlation coefficients between pCASL and IMP SPECT. We also calculated the asymmetry index (AI) using ROIs in contralateral regions of the hemispheres.Results: The rCBF values calculated from pCASL and IMP SPECT were comparable in most segments, but rCBF in the thalamus (P < 0.0001) and hippocampus (P = 0.0006) was significantly higher measured by pCASL than IMP SPECT. The correlation of rCBF between pCASL and IMP SPECT in the affected hemisphere (r = 0.50) tended to be lower than that in the normal hemisphere (r = 0.59), but not significantly different (P = 0.25). Moreover, there was a fixed bias for underestimation of rCBF by pCASL (P = 0.0047) in the affected hemisphere. The calculated AI showed a significant relationship between methods (r = 0.79, P < 0.0001).Conclusion: The rCBF obtained by pCASL had positive relationships with IMP SPECT. However, it should be considered that pCASL tends to have a weak relationship with IMP SPECT in some normal regions and regions affected by cerebrovascular occlusive disease.

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Section: Discussionmentioning

confidence: 94%

Operator-bias-free Comparison of Quantitative Perfusion Maps Acquired with Pulsed-continuous Arterial Spin Labeling and Single-photon-emission Computed Tomography

Iwanaga

Harada

Kubo

et al. 2014

MRMS

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“…Three-dimensional gradient and spin echo ASL has very recently been shown to be sensitive enough to demonstrate mild perfusion changes related to differences in physiological conditions (e.g. hypercapnia) [21]. …”

Section: Discussionmentioning

confidence: 99%

Continuous Magnetic Resonance Perfusion Imaging Acquisition during Systemic Thrombolysis in Acute Stroke

et al. 2013

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Background: Early recanalization and increase in collateral blood supply are powerful predictors of favourable outcome in acute ischaemic stroke. The factors contributing to the heterogeneous response to intravenous thrombolysis therapy in individual patients, however, are not fully understood. The on-going single-centre ‘MR perfusion imaging during thrombolysis' study uses repetitive arterial spin labelling (ASL) measurements to characterize the haemodynamic processes in acute stroke during therapy. The first milestone was to develop an appropriate infrastructure for thrombolysis in the magnetic resonance imaging (MRI) scanner without time delay and ensuring optimal patient safety and care. Methods: Between February and December 2011, 16 patients with acute neurological symptoms suggestive of hemispheric stroke within 4.5 h after symptom onset were included. In addition to clinical data, we documented the time from onset to arrival at the hospital, start and duration of MRI examination, start of thrombolytic therapy, and complications. The decision to thrombolyse was made after a routine stroke MRI protocol. During the 60-min systemic thrombolysis, repetitive ASL perfusion imaging was acquired, providing non-invasive information on cerebral perfusion. Continuous ECG monitoring, pulse oximetry, blood pressure measurements every 5 min, and short neurological assessments every 15 min were performed in every patient. Results: The median initial NIHSS score of the patients presenting with a mean of 84 min after onset was 4 (range 2-18). MRI examination was initiated within a mean of 45 min after arrival at the hospital. Five patients identified as stroke mimics were not treated with recombinant tissue plasminogen activator (rt-PA), and in 1 case with basilar artery occlusion bridging therapy was performed outside the scanner. In the remaining 10 patients, rt-PA therapy was started in the scanner directly after decision making on the basis of clinical information and baseline MRI. The mean door-to-needle time was 60 min (range 44-115) including approximately 10 min needed for acquiring informed consent. While 4 patients required antihypertensive treatment, no relevant complications were encountered. Conclusions: Fast and safe medical care in patients during systemic thrombolysis in the MRI scanner is feasible. Despite the process of obtaining informed consent, with a dedicated and experienced stroke team the door-to-needle time can be kept in a range recommended by current guidelines. Continuous real-time information about the dynamics of cerebral perfusion from ASL perfusion in acute stroke patients undergoing thrombolysis may provide additional information for the understanding of the events following acute arterial obstruction and its course.

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“…Some brain structures should be able to be distinguished in the CBF maps, such as the corpus callosum with low blood flow. Figure adapted from Tanaka et al [12]…”

Section: Figmentioning

confidence: 99%

Quantitative Cerebral Blood Flow Measurements Using MRI

Muir¹,

Watts²,

Tiwari³

et al. 2014

Methods in Molecular Biology

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Magnetic resonance imaging utilized as a quantitative and noninvasive method to image cerebral blood flow. The two most common techniques used to detect cerebral blood flow are dynamic susceptibility contrast (DSC) perfusion MRI and arterial spin labeling perfusion MRI. Herein we describe the use of these two techniques to measure cerebral blood flow in rodents, including methods, analysis, and important considerations when utilizing these techniques.

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Arterial spin labeling and dynamic susceptibility contrast CBF MRI in postischemic hyperperfusion, hypercapnia, and after mannitol injection

Cited by 47 publications

References 43 publications

Operator-bias-free Comparison of Quantitative Perfusion Maps Acquired with Pulsed-continuous Arterial Spin Labeling and Single-photon-emission Computed Tomography

Operator-bias-free Comparison of Quantitative Perfusion Maps Acquired with Pulsed-continuous Arterial Spin Labeling and Single-photon-emission Computed Tomography

Continuous Magnetic Resonance Perfusion Imaging Acquisition during Systemic Thrombolysis in Acute Stroke

Quantitative Cerebral Blood Flow Measurements Using MRI

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