Histopathologic correlates of abnormal water diffusion in cerebral ischemia: diffusion-weighted MR imaging and light and electron microscopic study.

Pierpaoli, Carlo; Righini, Andrea; Linfante, Italo; Tao-Cheng, Jung-Hwa; Alger, J. R.; Chiro, Giovanni Di

doi:10.1148/radiology.189.2.8210373

Cited by 189 publications

(116 citation statements)

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“…4). This result is consistent withˆndings in animal studies that suggested water accumulation mainly in the intracellular space in ischemic edema, even when accompanied by hyperintensity on T2-weighted image, at 6 hours 11 and cytotoxicity of edema one through 2 days 43 after onset of ischemia. Thus, the mechanism underlying decreases in FA, R2, and <ADC> during Phase 2 may be accumulation of water in the vacuoles rather than in the extracellular space.…”

Section: Magnetic Resonance In Medical Sciencessupporting

confidence: 92%

“…Although the decrease is generally attributed to cellular edema and the increase to vasogenic edema and degradation of membrane structure, 1,[10][11][12] the exact mechanisms of these changes in <ADC> remain unclear.…”

Section: Magnetic Resonance In Medical Sciencesmentioning

confidence: 99%

“…4 Many studies have demonstrated temporal evolution of the mean diŠusivity (<ADC>, trace/3 of the diŠusion tensor) in patients with stroke. [5][6][7][8][9][10][11][12][13] Follow-Magnetic Resonance in Medical Sciences ing acute reduction of <ADC> after the onset of cerebral ischemia, <ADC> decreases slightly over 24 hours in many cases, [5][6][7][8][9] reaches a minimum, gradually increases to a normal value (pseudonormalization) between several days and one month, and continues to increase. Although the decrease is generally attributed to cellular edema and the increase to vasogenic edema and degradation of membrane structure, 1,[10][11][12] the exact mechanisms of these changes in <ADC> remain unclear.…”

Section: Introductionmentioning

confidence: 99%

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How Does Water Diffusion in Human White Matter Change Following Ischemic Stroke?

Tamura¹,

Kurihara

Machida³

et al. 2009

magn reson med sci

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Purpose: Temporal evolution of the water apparent diŠusion coe‹cients (ADC) parallel (ADC¿) and perpendicular (ADC¥) to the human white matter tract following ischemia has not been investigated systematically. We attempted to quantify the evolution of ADC¿ and ADC¥ and examine whether it can be interpreted by a model of ischemic edema.Methods: We retrospectively selected 53 patients with ischemic lesions involving the posterior limb of the internal capsule (PLIC) and placed regions of interest in the right and left PLIC on ADC maps. We performed regression analysis of lesion-to-contralateral ratios of ADC¿ and ADC¥against the time (t＝1-1600 h) from onset. We thenˆtted the estimated time courses of ADC¿ and ADC¥obtained from the analysis to a model of nerve tissue composed of cylinders (axons) and spheres corresponding to isotropic structures, particularly focal cytoplasmic swellings of glial cells and axons seen in ischemic white matter.Results: The evolution of ADC¥ and ADC¿ diŠered. The estimated time course of ADC¿ in mm 2 ･ms -1 was 0.64＋0.88 exp (-0.24t) for 1ºtº54 h and 0.00059t＋0.61 for tAE54 h (contralateral normal value, 1.52). That of ADC¥ was 0.19-0.063 exp (-0.24t) for 1ºtº54 h and 0.00040t＋0.17 for tAE54 h (normal value 0.22). The modelˆtted to these values showed that the volume of the cylinders decreased, that of the spheres increased, and extracellular volume changed little from one hour to approximately one day after stroke onset.Conclusion: In the human PLIC, ADC¿ continued to decrease from one hour to a few days after stroke onset, and ADC¥tended to increase. The temporal evolution could be interpreted by progression of the focal cytoplasmic swelling of glial cells and axons previously observed in animal studies.Keywords: cytotoxic edema, glia, intracellular space, vasogenic edema Introduction DiŠusion-weighted (DW) magnetic resonance (MR) imaging enables noninvasive measurement of the diŠusivity of water molecules in the human brain. Prompt reduction of the apparent diŠusion coe‹cient (ADC) in ischemic tissue causes hyperintensity on DW images, which aids detection of early changes in the brain after onset of ischemic stroke. [1][2][3] ADC measurement may also be useful in characterizing ischemic damage and selecting therapeutic procedure. 4 Many studies have demonstrated temporal evolution of the mean diŠusivity (, trace/3 of the diŠusion tensor) in patients with stroke. 5-13Follow-122 122 H. Tamura et al. Magnetic Resonance in Medical Sciencesing acute reduction of after the onset of cerebral ischemia, decreases slightly over 24 hours in many cases, [5][6][7][8][9] reaches a minimum, gradually increases to a normal value (pseudonormalization) between several days and one month, and continues to increase. Although the decrease is generally attributed to cellular edema and the increase to vasogenic edema and degradation of membrane structure, 1,[10][11][12] the exact mechanisms of these changes in remain unclear.Human and animal studies show a decline in diŠusion anisot...

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Section: Magnetic Resonance In Medical Sciencessupporting

confidence: 92%

Section: Magnetic Resonance In Medical Sciencesmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

How Does Water Diffusion in Human White Matter Change Following Ischemic Stroke?

Tamura¹,

Kurihara

Machida³

et al. 2009

magn reson med sci

View full text Add to dashboard Cite

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“…Diffusion tensor imaging is a new MRI modality based on the measurements of the random motion of water molecules (Basser and Jones, 2002;Basser and Pierpaoli, 1996;Le Bihan, 1995;Le Bihan et al, 2001;Le Bihan and van Zijl, 2002;Pierpaoli et al, 1993Pierpaoli et al, , 1996. Water molecules interact with many tissue components such as cell membranes, myelin, and macromolecules, which provides unique clues to the tissue architecture at the microscopic level.…”

Section: Introductionmentioning

confidence: 99%

Longitudinal Diffusion Changes in Cerebral Hemispheres after MCA Infarcts

Buffon

Molko

Hervé

et al. 2005

J Cereb Blood Flow Metab

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Diffusion tensor imaging can be used in vivo to assess the longitudinal and regional microstructural changes occurring after middle cerebral artery (MCA) infarcts in humans. Nine patients were investigated 1 week (D7), 1 (M1), 3 (M3), and 6 months (M6) after the occurrence of an isolated MCA infarction. First, an overall analysis was performed using histograms of mean diffusivity (MD) and fractional anisotropy (FA) in each hemisphere. Thereafter, the regional pattern of diffusion changes was investigated voxel by voxel with statistical parametric mapping 99. In the hemisphere ipsilateral to the infarction, histogram analysis revealed a significant decrease in FA between D7 and M6 associated with a progressive increase in MD from D7 to M3. Remote from the MCA territory, the voxel by voxel analyses detected a significant increase in MD within the thalamus at M3 and M6 and a reduction in FA along the pyramidal tract at M6. In the contralateral hemisphere, between D7 and M6, a significant hemispheric atrophy was observed in association with a global reduction in anisotropy, in the absence of distinctive regional diffusion changes. These results suggest that micro-and macrostructural tissue modifications can be detected with diffusion tensor imaging in regions remote from the ischemic area in both hemispheres.

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“…Notably, if mild vasogenic edema evolves with a dosedependent injury in the 56 Fe-irradiated brain, extravagated fluid could shift to the cytoplasm of the reactive astrocytes without significant enlargement of the extracellular space (32). The increase of net water content may be responsible for T2 prolongation in animals exposed to high doses of 56 Fe particles.…”

Section: Discussionmentioning

confidence: 99%

Neuroimaging assessment of memory‐related brain structures in a rat model of acute space‐like radiation

Huang¹,

Smith²,

Cummings³

et al. 2009

Magnetic Resonance Imaging

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Purpose: To investigate the acute effects on the central nervous system (CNS) of 56 Fe radiation, a component of high-energy charged particles (HZE) in space radiation, using quantitative magnetic resonance imaging (MRI) noninvasively. Materials and Methods:Sprague-Dawley rats were exposed to whole-brain 56 Fe (0, 1, 2, and 4 Gy). At 1 week postirradiation, MRI scans were made using T2-weighted (T2WI), diffusion-weighted (DWI), and contrast enhanced T1-(CET1) imaging. T2 relaxation time and apparent diffusion coefficient (ADC) values were obtained from memoryrelated brain regions of interest (ROIs). Histopathology was correlated using ex vivo tissues. Results:No overt abnormalities were visualized using T2WI and DWI at 1 week postradiation. CET1 values did not differ significantly between the irradiated and control animals. Compared to 0 Gy, there were significant prolongations in T2 values and reductions in ADC after irradiation. In the absence of evident neuronal pathology, immunohistochemistry revealed astrocytic activation in 4 Gy animals. Conclusion:At 1 week after whole-brain 56 Fe exposure, T2 and ADC values can differentiate radiosensitivity in regions critical for hippocampal-related memory. MRI may provide noninvasive assessment of the initial molecular/cellular disturbances in vivo after HZE irradiation.

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Histopathologic correlates of abnormal water diffusion in cerebral ischemia: diffusion-weighted MR imaging and light and electron microscopic study.

Abstract: Diffusion-weighted images may help ascertain the extent of cellular damage and death after stroke.

Cited by 189 publications

References 0 publications

How Does Water Diffusion in Human White Matter Change Following Ischemic Stroke?

How Does Water Diffusion in Human White Matter Change Following Ischemic Stroke?

Longitudinal Diffusion Changes in Cerebral Hemispheres after MCA Infarcts

Neuroimaging assessment of memory‐related brain structures in a rat model of acute space‐like radiation

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