Document Detail


Quantitative cerebral MR perfusion imaging: preliminary results in stroke.
MedLine Citation:
PMID:  20882609     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: To evaluate quantitative cerebral blood flow (qCBF) with traditional time-based measurements or metrics of cerebral perfusion: time to peak (Tmax) and mean transit time (MTT) in stroke patients.
MATERIALS AND METHODS: Nine ischemic stroke patients (four male, five female, 63 ± 16 years old) were included in the study which was Health Insurance Portability and Accountability Act compliant and institutional review board approved. Cerebral perfusion was quantified using the Bookend method. Mean values of qCBF, Tmax, and MTT were determined in regions of interest (ROIs). ROIs were drawn on diffusion weighted images in diffusion positive, critically ischemic (CI), in ipsilateral normal region immediately surrounding the critically ischemic region, the presumed penumbra (PP), and in contralateral diffusion negative control, presumed normal region (PN) of gray and white matter separately (GM and WM).
RESULTS: In both GM and WM, qCBF measures distinguished the studied brain regions with the most markedly reduced values in regions corresponding to extent of likely ischemic injury. In planned comparisons, only qCBF measurements differed significantly between CI and PP tissues. ROC analysis supported the utility of qCBF for discriminating brain regions differing in the likely extent of ischemic injury (CI and PN regions - qCBF: area under the curve [AUC] = 0.96, Tmax: AUC = 0.96, MTT: AUC = 0.72). Importantly, qCBF afforded the best discrimination of CI and PP regions (qCBF: AUC = 0.82, Tmax: AUC = 0.65, MTT: AUC = 0.52).
CONCLUSION: This initial evaluation indicates that quantitative MRI perfusion is feasible in ischemic stroke patients. qCBF derived with this strategy provide enhanced discrimination of CI and PP compared to time-based imaging metrics. This approach merits investigation in larger clinical studies.
Authors:
Maulin K Shah; Wanyong Shin; Vishal S Parikh; Ann Ragin; Jessy Mouannes; Richard A Bernstein; Matthew T Walker; Hem Bhatt; Timothy J Carroll
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of magnetic resonance imaging : JMRI     Volume:  32     ISSN:  1522-2586     ISO Abbreviation:  J Magn Reson Imaging     Publication Date:  2010 Oct 
Date Detail:
Created Date:  2010-09-30     Completed Date:  2011-02-02     Revised Date:  2012-05-07    
Medline Journal Info:
Nlm Unique ID:  9105850     Medline TA:  J Magn Reson Imaging     Country:  United States    
Other Details:
Languages:  eng     Pagination:  796-802     Citation Subset:  IM    
Affiliation:
Department of Biomedical Engineering, Northwestern University, Evanston, Illinois 60611, USA.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Area Under Curve
Brain / pathology
Brain Ischemia / pathology
Female
Humans
Image Processing, Computer-Assisted
Magnetic Resonance Imaging / methods*
Male
Middle Aged
Perfusion Imaging / methods*
Stroke / diagnosis,  physiopathology*
Treatment Outcome
Grant Support
ID/Acronym/Agency:
1R01 NS0493395/NS/NINDS NIH HHS; R01 NS049395-01A2/NS/NINDS NIH HHS; R01 NS049395-02/NS/NINDS NIH HHS; R01 NS049395-03/NS/NINDS NIH HHS; R01 NS049395-04/NS/NINDS NIH HHS; T32 EB005170-05/EB/NIBIB NIH HHS
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