How affected is oxygen metabolism in DWI lesions?: A combined acute stroke PET-MR study
| Autor: | P.S. Jones, Olivier Barret, Tim D. Fryer, Sally G. Harding, C.J. Price, Franklin I. Aigbirhio, Joseph V. Guadagno, Elizabeth A. Warburton, Jean-Claude Baron, Jonathan H. Gillard, H.A.L. Green, Diana J. Day |
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| Rok vydání: | 2006 |
| Předmět: |
Male
Magnetic Resonance Spectroscopy Ischemia Lesion Central nervous system disease Image Processing Computer-Assisted medicine Humans Prospective Studies cardiovascular diseases Stroke Aged Aged 80 and over Brain Mapping medicine.diagnostic_test business.industry Brain Middle Aged medicine.disease Oxygen Diffusion Magnetic Resonance Imaging Cerebral blood flow Regional Blood Flow Positron emission tomography Positron-Emission Tomography Female Neurology (clinical) medicine.symptom Energy Metabolism Nuclear medicine business Perfusion Diffusion MRI |
| Zdroj: | Neurology. 67:824-829 |
| ISSN: | 1526-632X 0028-3878 |
| DOI: | 10.1212/01.wnl.0000233984.66907.db |
| Popis: | Objective: To use back-to-back diffusion-weighted imaging (DWI) and PET to obtain quantitative measures of the cerebral metabolic rate of oxygen (CMRO 2 ) within DWI lesions, and to assess the perfusion-metabolism coupling status by measuring the cerebral blood flow and the oxygen extraction fraction within DWI lesions. Methods: Six prospectively recruited acute carotid-territory stroke patients completed the imaging protocol, which was commenced 7 to 21 hours from onset and combined DWI derived from state-of-the-art diffusion tensor imaging sequencing using a 3-T magnet and fully quantitative 15 O-PET. The PET variables were obtained in individual DWI lesions in each patient. Results: Across patients, the CMRO 2 was reduced in the DWI lesion relative to mirror (mean reduction 39.5%; p = 0.028). Examining individual DWI lesions, however, revealed considerable variability in the extent of this CMRO 2 reduction. The flow–metabolism coupling pattern underlying the DWI lesion was also variable, including ongoing ischemia, mild oligemia, and partial or complete reperfusion. Discussion: Diffusion-weighted imaging (DWI) lesions generally reflect substantial disruption of energy metabolism. However, the degree of metabolic disruption is variable, indicating DWI lesions may not always represent irreversibly damaged tissue. Finally, because DWI lesions can persist despite reperfusion, assessment of perfusion is necessary for interpretation of DWI changes in acute stroke. |
| Databáze: | OpenAIRE |
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