Theoretical Basis of Hemodynamic MR Imaging Techniques to Measure Cerebral Blood Volume, Cerebral Blood Flow, and Permeability

Zaharchuk, Greg

doi:10.3174/ajnr.a0831

Cited by 119 publications

(90 citation statements)

References 46 publications

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“…In contrast to DSC perfusion MR imaging, ASL methods measure CBF only. 29 Although attempts have been made to determine CBV with ASL techniques in animal models, they cannot yet be applied in clinical practice. 30,31 Because earlier reports by using DSC perfusion MR imaging showed a strong correlation between the rCBV and rCBF ratios in high-and lowgrade gliomas, 32,33 we used rCBF ratios to compare tumor perfusion obtained by DSC and ASL methods.…”

Section: Discussionmentioning

confidence: 99%

Quantitative Blood Flow Measurements in Gliomas Using Arterial Spin-Labeling at 3T: Intermodality Agreement and Inter- and Intraobserver Reproducibility Study

Hirai¹,

Kitajima²,

Nakamura

et al. 2011

AJNR Am J Neuroradiol

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Section: Discussionmentioning

confidence: 99%

Quantitative Blood Flow Measurements in Gliomas Using Arterial Spin-Labeling at 3T: Intermodality Agreement and Inter- and Intraobserver Reproducibility Study

Hirai¹,

Kitajima²,

Nakamura

et al. 2011

AJNR Am J Neuroradiol

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“…16 This signal is caused by the mild T1-weighting of a predominantly T2*-weighted sequence. When present, this signal is opposite to the T2* effect.…”

mentioning

confidence: 99%

Pretreatment blood–brain barrier disruption and post-endovascular intracranial hemorrhage

et al. 2016

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Objective: This study sought to confirm the relationship between the degree of blood-brain barrier (BBB) damage and the severity of intracranial hemorrhage (ICH) in a population of patients who received endovascular therapy. Methods:The degree of BBB disruption on pretreatment MRI scans was analyzed, blinded to follow-up data, in the DEFUSE 2 cohort in which patients had endovascular therapy within 12 hours of stroke onset. BBB disruption was compared with ICH grade previously established by the DEFUSE 2 core lab. A prespecified threshold for predicting parenchymal hematoma (PH) was tested.Results: Of the 108 patients in the DEFUSE 2 trial, 100 had adequate imaging and outcome data and were included in this study; 24 developed PH. Increasing amounts of BBB disruption on pretreatment MRIs was associated with increasing severity of ICH grade (p 5 0.004). BBB disruption on the pretreatment scan was associated with PH (p 5 0.020) with an odds ratio for developing PH of 1.69 for each 10% increase in BBB disruption (95% confidence interval 1.09-2.64), although a reliably predictive threshold was not identified. Conclusions:The amount of BBB disruption on pretreatment MRI is associated with the severity of ICH after acute intervention. This relationship has now been identified in patients receiving IV, endovascular, and combined therapies. Further study is needed to determine its role in guiding treatment. Neurology ® 2016;87:263-269 GLOSSARY BBB 5 blood-brain barrier; BBPI 5 blood-brain permeability image; DSC 5 dynamic susceptibility contrast; DWI 5 diffusionweighted imaging; ECASS 5 European Cooperative Acute Stroke Study; GRE 5 gradient echo; HI 5 hemorrhagic infarct; ICH 5 intracranial hemorrhage; PH 5 parenchymal hematoma; PWI 5 perfusion-weighted imaging; ROC 5 receiver operator characteristic; ROI 5 region of interest; tPA 5 tissue plasminogen activator.Recent studies have validated the use of endovascular therapy in the treatment of acute stroke. [1][2][3][4][5] Initial studies that failed to show benefit of endovascular therapy omitted imaging-based selection criteria. 6,7 The first trial to demonstrate that imaging could be used to select a population of patients who would benefit from endovascular therapy was the DEFUSE 2 trial.8 Although the MR RESCUE study subsequently challenged the utility of imaging selection, 9 post hoc comparisons of these 2 trials have identified several limitations to the MR RESCUE trial that likely accounted for its negative results. 10,11The first randomized trial to show benefit simply used large vessel occlusion for imaging selection.1 The absolute benefit of endovascular therapy was greater in subsequent trials that used imaging to exclude patients with large ischemic core or poor collateral blood flow.2,3,5 The DEFUSE 2 trial identified an MRI profile most likely to benefit from endovascular therapy simply using lesion volumes from diffusion-weighted imaging (DWI) and perfusion-weighted imaging (PWI). However, multimodal MRI contains additional information that may be...

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“…[3][4][5] On DSC perfusion MR imaging, PCNSLs demonstrate lower CBV compared with glioblastomas. [6][7][8][9][10][11][12][13][14] In lesions with substantial BBB breakdown and contrast leakage, the T2*-weighted signal-intensity loss can be masked by signal-intensity increase secondary to T1 effects.…”

mentioning

confidence: 99%

Differentiation of Primary Central Nervous System Lymphomas and Glioblastomas: Comparisons of Diagnostic Performance of Dynamic Susceptibility Contrast-Enhanced Perfusion MR Imaging without and with Contrast-Leakage Correction

Toh¹,

Wei

Chang

et al. 2013

AJNR Am J Neuroradiol

105

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Theoretical Basis of Hemodynamic MR Imaging Techniques to Measure Cerebral Blood Volume, Cerebral Blood Flow, and Permeability

Cited by 119 publications

References 46 publications

Quantitative Blood Flow Measurements in Gliomas Using Arterial Spin-Labeling at 3T: Intermodality Agreement and Inter- and Intraobserver Reproducibility Study

Quantitative Blood Flow Measurements in Gliomas Using Arterial Spin-Labeling at 3T: Intermodality Agreement and Inter- and Intraobserver Reproducibility Study

Pretreatment blood–brain barrier disruption and post-endovascular intracranial hemorrhage

Differentiation of Primary Central Nervous System Lymphomas and Glioblastomas: Comparisons of Diagnostic Performance of Dynamic Susceptibility Contrast-Enhanced Perfusion MR Imaging without and with Contrast-Leakage Correction

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