| Novel MRI detection of the ischemic penumbra: direct assessment of metabolic integrity. | |
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MedLine Citation:
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PMID: 21751274 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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We describe a novel magnetic resonance imaging technique to directly assess the metabolic integrity of penumbral tissue following stroke. For ischemically stressed tissue to be salvageable, it has to be capable of recovering aerobic metabolism (in place of anaerobic metabolism) on reperfusion. We probed ischemic brain tissue by altering the rate of oxygen delivery using a challenge of 100% oxygen ventilation. Any change from anaerobic to aerobic metabolism should alter the rate of lactate production and hence, levels of tissue lactate. Stroke was induced by permanent middle cerebral artery occlusion in rats. In Series 1 (n = 6), changes in tissue lactate during and following 100% oxygen challenge were monitored using (1) H magnetic resonance spectroscopy (MRS). Diffusion weighted imaging (DWI) and perfusion weighted imaging (PWI) were used to locate MRS voxels within the ischemic core, the homotopic contralateral striatum and within PWI/DWI mismatch (i.e. presumed penumbra). After 20 min of oxygen, lactate signal change was -16.1 ± 8.8% (mean ± SD) in PWI/DWI mismatch, +2.8 ± 5.1% in the ischemic core, and -0.6 ± 7.6% in the contralateral striatum. Return to air ventilation for 20 min resulted in a reversal, with lactate increasing by 46 ± 25.3% in the PWI/DWI mismatch, 6.6 ± 6.2% in the ischemic core, and -5 ± 11.4% in the contralateral striatum. In Series 2 (n = 6), a novel form of spectroscopic imaging was used to acquire lactate change maps to spatially identify regions of lactate change within the ischemic brain. This technique has potential clinical utility by identifying tissue that displays anaerobic metabolism capable of recovering aerobic metabolism when oxygen delivery is increased, which could provide a more precise assessment of penumbra. Copyright © 2011 John Wiley & Sons, Ltd. |
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Authors:
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William M Holmes; Maria R Lopez-Gonzalez; Lindsay Gallagher; Graeme A Deuchar; I Mhairi Macrae; Celestine Santosh |
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Publication Detail:
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Type: JOURNAL ARTICLE Date: 2011-7-12 |
Journal Detail:
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Title: NMR in biomedicine Volume: - ISSN: 1099-1492 ISO Abbreviation: - Publication Date: 2011 Jul |
Date Detail:
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Created Date: 2011-7-13 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8915233 Medline TA: NMR Biomed Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Copyright Information:
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Copyright © 2011 John Wiley & Sons, Ltd. |
Affiliation:
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Glasgow Experimental MRI Centre, Division of Clinical Neuroscience, Faculty of Medicine, University of Glasgow, G61 1QH, UK. wmh5b@udcf.gla.ac.uk. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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