Measurement of collateral perfusion in acute stroke: a vessel-encoded arterial spin labeling study

Okell, Thomas W.; Harston, George; Chappell, Michael A.; Sheerin, Fintan; Kennedy, James; Jezzard, Peter

doi:10.1038/s41598-019-44417-7

Cited by 24 publications

(18 citation statements)

References 43 publications

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“…In the current study, the mismatch ratio was computed as a ratio of penumbra volume and ischemic core volume. 30 For volume calculations, standard accepted procedure 31 was followed. In the current study, a methodology for automatic penumbra-ROI selection on PHVS/SWI images was proposed as described in the next section.…”

Section: Mismatch Ratio Calculationsmentioning

confidence: 99%

Penumbra quantification from MR SWI‐DWI mismatch and its comparison with MR ASL PWI‐DWI mismatch in patients with acute ischemic stroke

et al. 2021

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In acute-ischemic-stroke patients, penumbra assessment plays a significant role in treatment outcome. MR perfusion-weighted imaging (PWI) and diffusion-weighted imaging (DWI) mismatch ratio can provide penumbra assessment. Recently reported studies have shown the potential of susceptibility-weighted imaging (SWI) in the qualitative assessment of penumbra. We hypothesize that quantitative penumbra assessment using SWI-DWI can provide an alternative to the PWI-DWI approach and this can also reduce the overall scan-time. The purpose of the current study was to develop a framework for accurate quantitative assessment of penumbra using SWI-DWI and its validation with PWI-DWI-based quantification. In the current study, the arterial-spin-labelling (ASL) technique has been used for PWI. This retrospective study included 25 acute-ischemic-stroke patients presenting within 24 hours of the last noted baseline condition of stroke onset. Eleven patients also had follow-up MRI within 48 hours. MRI acquisition comprised DWI, SWI, pseudo-continuous-ASL (pCASL), FLAIR and non-contrast-angiography sequences. A framework was developed for the enhancement of prominent hypo-intense vein signs followed by automatic segmentation of the SWI penumbra ROI. Apparent-diffusion-coefficient (ADC) maps and cerebral-blood-flow (CBF) maps were computed. The infarct core ROI from the ADC map and the ASL penumbra ROI from CBF maps were segmented semiautomatically. The infarct core volume, SWI penumbra volume (SPV) and pCASL penumbra volume were computed and used to calculate mismatch ratios MR SWI ADC

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Section: Mismatch Ratio Calculationsmentioning

confidence: 99%

Penumbra quantification from MR SWI‐DWI mismatch and its comparison with MR ASL PWI‐DWI mismatch in patients with acute ischemic stroke

et al. 2021

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“…Collateral status is usually assessed on CTA. Current approaches of collateral assessment are predominantly based on static grading scores; however, some studies have looked at collateral perfusion to evaluate the dynamic properties of collateral vessel filling, using advanced imaging modalities such as mCTA (Menon, d'Esterre, et al, 2015) and ASL (Okell et al, 2019a). The various phases of time-resolved images in mCTA can be used to evaluate collateral arterial filling de Havenon et al, 2019;Elijovich et al, 2016).…”

Section: Collateral Assessment With Static and Dynamic Gradingmentioning

confidence: 99%

Cerebral collaterals in acute ischaemia: Implications for acute ischaemic stroke patients receiving reperfusion therapy

Ravindran

Killingsworth

Bhaskar

2020

Eur J of Neuroscience

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The cerebral collaterals play an important role in penumbral tissue sustenance after an acute ischaemic stroke. Recent studies have demonstrated the potential role of collaterals in the selection of acute ischaemic stroke patients eligible for reperfusion therapy. However, the understanding of the significance and evidence around the role of collateral status in predicting outcomes in acute ischaemic stroke patients treated with reperfusion therapy is still unclear. Moreover, the use of pre-treatment collaterals in patient selection and prognosis is relatively underappreciated in clinical settings. A focused review of the literature was performed on the various methods of collateral evaluation and the role of collateral status in acute ischaemic stroke patients receiving reperfusion therapy. We discuss the methods of evaluating pre-treatment collaterals in clinical settings. The patient selection based on collateral status as well as the prognostic and therapeutic value of collaterals in acute ischaemic stroke, in settings of intravenous thrombolysis or endovascular therapy alone, and bridge therapy, are summarized. Recommendations for future research and possible pharmacological intervention strategies aimed at collateral enhancement are also discussed. Collaterals may play an important role in identifying acute ischaemic stroke patients who are likely to benefit from endovascular treatment in an extended time window. Future neuroscientific efforts to better improve our understanding of the role of collaterals in | 1239 VISHNI RAVINDRAN et Al.

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“…Dynamic Susceptibility-weighted Contrast-enhanced Magnetic Resonance Imaging (DSC-MRI) perfusion, Computed-Tomography (CT)-perfusion, Arterial Spin Labeling (ASL) perfusion or functional MRI. 10,11,12,13,14 These techniques may harm patients through contrast agents, significantly prolong the time to treatment and lead to increased costs. Also, standardization of these complex methods is highly challenging.…”

Section: Introductionmentioning

confidence: 99%

A Precision Medicine Framework for Personalized Simulation of Hemodynamics in Cerebrovascular Disease

Frey

Livne

Leppin

et al. 2021

Preprint

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Cerebrovascular disease, in particular stroke, is a major public health challenge. An important biomarker is cerebral hemodynamics. To measure and quantify cerebral hemodynamics, however, only invasive, potentially harmful or time-to-treatment prolonging methods are available. We present a simulation-based approach which allows calculation of cerebral hemodynamics based on the patient-individual vessel configuration derived from structural vessel imaging. For this, we implemented a framework allowing segmentation and annotation of brain vessels from structural imaging followed by 0-dimensional lumped simulation modelling of cerebral hemodynamics. For annotation, a 3D-graphical user interface was implemented. For 0D-simulation, we used a modified nodal analysis, which was adapted for easy implementation by code. The simulation enables identification of areas vulnerable to stroke and simulation of changes due to different systemic blood pressures. Moreover, sensitivity analysis was implemented allowing the live simulation of changes to simulate procedures and disease progression. Beyond presentation of the framework, we demonstrated in an exploratory analysis in 67 patients that the simulation has a high specificity and low to moderate sensitivity to detect perfusion changes in classic perfusion imaging. The presented precision medicine approach using novel biomarkers has the potential to make the application of harmful and complex perfusion methods obsolete.

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Measurement of collateral perfusion in acute stroke: a vessel-encoded arterial spin labeling study

Cited by 24 publications

References 43 publications

Penumbra quantification from MR SWI‐DWI mismatch and its comparison with MR ASL PWI‐DWI mismatch in patients with acute ischemic stroke

Penumbra quantification from MR SWI‐DWI mismatch and its comparison with MR ASL PWI‐DWI mismatch in patients with acute ischemic stroke

Cerebral collaterals in acute ischaemia: Implications for acute ischaemic stroke patients receiving reperfusion therapy

A Precision Medicine Framework for Personalized Simulation of Hemodynamics in Cerebrovascular Disease

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