Document Detail


Significance of the perfusion-diffusion mismatch in chronic cerebral ischemia.
MedLine Citation:
PMID:  16941614     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: To determine whether the perfusion deficit could predict brain infarction in patients with chronic cerebral ischemia who experienced recurring episodes of neurological symptoms and showed a perfusion-diffusion mismatch on magnetic resonance (MR) images. MATERIALS AND METHODS: In 53 consecutive patients (38 males and 15 females, 62+/-13 years old) with ischemia in the middle cerebral artery (MCA) territory, lesion volumetry was performed on parametric maps of the time-to-peak, the cerebral blood volume, and diffusion-weighted (DW) images. The infarct lesions were assessed on follow-up T2-weighted (T2W) MR images after eight days. Cerebrovascular changes were determined by time-of-flight (TOF) MR angiography (MRA). Inferential and correlation statistics were used. RESULTS: Patients with chronic ischemic brain disease (N=39) who presented with a severe perfusion-diffusion mismatch in the presence of a normal cerebral blood volume had no or small brain infarctions as found on follow-up T2W images. MRA revealed widespread abnormalities of the basal cerebral arteries compatible with brain perfusion abnormalities. In contrast, in acute stroke patients (N=14) the deficit of cerebral perfusion predicted the infarct lesion in the T2W images. CONCLUSION: Our results suggest that in chronic cerebral ischemia the normal blood volume was maintained despite the depression of cerebral perfusion and recurring minor insults.
Authors:
Irina Surikova; Stefanie Meisel; Mario Siebler; Hans-Jörg Wittsack; Rüdiger J Seitz
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of magnetic resonance imaging : JMRI     Volume:  24     ISSN:  1053-1807     ISO Abbreviation:  J Magn Reson Imaging     Publication Date:  2006 Oct 
Date Detail:
Created Date:  2006-09-28     Completed Date:  2007-01-23     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9105850     Medline TA:  J Magn Reson Imaging     Country:  United States    
Other Details:
Languages:  eng     Pagination:  771-8     Citation Subset:  IM    
Copyright Information:
Copyright (c) 2006 Wiley-Liss, Inc.
Affiliation:
Department of Neurology, Heinrich Heine University, Düsseldorf, Germany.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Blood Flow Velocity / physiology
Brain Ischemia / physiopathology*
Cerebral Infarction / physiopathology*
Cerebrovascular Circulation / physiology
Contrast Media
Diffusion Magnetic Resonance Imaging*
Female
Gadolinium DTPA / diagnostic use
Humans
Magnetic Resonance Angiography*
Male
Middle Aged
Predictive Value of Tests
Statistics, Nonparametric
Chemical
Reg. No./Substance:
0/Contrast Media; 80529-93-7/Gadolinium DTPA

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


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