Document Detail


Anoxic injury-associated cerebral hyperperfusion identified with arterial spin-labeled MR imaging.
MedLine Citation:
PMID:  18451089     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND AND PURPOSE: Anoxic brain injury is a devastating result of prolonged hypoxia. The goal of this study was to use arterial spin-labeling (ASL) to characterize the perfusion patterns encountered after anoxic injury to the brain. MATERIALS AND METHODS: Sixteen patients with a history of anoxic or hypoxic-ischemic injury ranging in age from 1.5 to 78.0 years (mean, 50.3 years) were analyzed with conventional MR imaging and pulsed ASL 1.0-13.0 days (mean, 4.6 days) after anoxic insult. The cerebral perfusion in each case was quantified by using pulsed ASL as part of the standard stroke protocol. Correlation was made among perfusion imaging, conventional imaging, clinical history, laboratory values, and outcome. RESULTS: Fifteen of the 16 patients showed marked global hyperperfusion, and 1 patient showed unilateral marked hyperperfusion. Mean gray matter (GM) cerebral blood flow (CBF) in these patients was 142.6 mL/100 g of tissue per minute (ranging from 79.9 to 204.4 mL/100 g of tissue per minute). Global GM CBF was significantly higher in anoxic injury subjects, compared with age-matched control groups with and without infarction (F(2,39) = 63.11; P < .001). Three patients had global hyperperfusion sparing areas of acute infarction. Conventional imaging showed characteristic restricted diffusion in the basal ganglia (n = 10) and cortex (n = 13). Most patients examined died (n = 12), with only 4 patients surviving at the 4-month follow-up. CONCLUSION: Pulsed ASL can dramatically demonstrate and quantify the severity of the cerebral hyperperfusion after a global anoxic injury. The global hyperperfusion probably results from loss of autoregulation of cerebral vascular resistance.
Authors:
J M Pollock; C T Whitlow; A R Deibler; H Tan; J H Burdette; R A Kraft; J A Maldjian
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't     Date:  2008-05-01
Journal Detail:
Title:  AJNR. American journal of neuroradiology     Volume:  29     ISSN:  1936-959X     ISO Abbreviation:  AJNR Am J Neuroradiol     Publication Date:  2008 Aug 
Date Detail:
Created Date:  2008-08-14     Completed Date:  2008-10-31     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8003708     Medline TA:  AJNR Am J Neuroradiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1302-7     Citation Subset:  IM    
Affiliation:
Department of Radiology, Wake Forest University School of Medicine, Winston-Salem, NC 27157, USA. jeffmpollock@gmail.com
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Blood Flow Velocity / physiology
Brain / blood supply*
Child
Child, Preschool
Dominance, Cerebral / physiology
Female
Heart Arrest / complications,  physiopathology
Homeostasis / physiology
Humans
Hyperemia / diagnosis*,  physiopathology
Hypoxia, Brain / diagnosis*,  etiology,  physiopathology
Image Enhancement / methods*
Image Processing, Computer-Assisted / methods*
Infant
Infarction, Middle Cerebral Artery / diagnosis,  physiopathology
Magnetic Resonance Angiography / methods*
Male
Middle Aged
Regional Blood Flow / physiology
Retrospective Studies
Vascular Resistance / physiology
Grant Support
ID/Acronym/Agency:
EB004673/EB/NIBIB NIH HHS; EB004673-02S2/EB/NIBIB NIH HHS

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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