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Asaduddin M, Kim EY, Park SH. SPINNED: Simulation-based physics-informed neural network for deconvolution of dynamic susceptibility contrast MRI perfusion data. Magn Reson Med 2024; 92:1205-1218. [PMID: 38623911 DOI: 10.1002/mrm.30095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Revised: 03/13/2024] [Accepted: 03/13/2024] [Indexed: 04/17/2024]
Abstract
PURPOSE To propose the simulation-based physics-informed neural network for deconvolution of dynamic susceptibility contrast (DSC) MRI (SPINNED) as an alternative for more robust and accurate deconvolution compared to existing methods. METHODS The SPINNED method was developed by generating synthetic tissue residue functions and arterial input functions through mathematical simulations and by using them to create synthetic DSC MRI time series. The SPINNED model was trained using these simulated data to learn the underlying physical relation (deconvolution) between the DSC-MRI time series and the arterial input functions. The accuracy and robustness of the proposed SPINNED method were assessed by comparing it with two common deconvolution methods in DSC MRI data analysis, circulant singular value decomposition, and Volterra singular value decomposition, using both simulation data and real patient data. RESULTS The proposed SPINNED method was more accurate than the conventional methods across all SNR levels and showed better robustness against noise in both simulation and real patient data. The SPINNED method also showed much faster processing speed than the conventional methods. CONCLUSION These results support that the proposed SPINNED method can be a good alternative to the existing methods for resolving the deconvolution problem in DSC MRI. The proposed method does not require any separate ground-truth measurement for training and offers additional benefits of quick processing time and coverage of diverse clinical scenarios. Consequently, it will contribute to more reliable, accurate, and rapid diagnoses in clinical applications compared with the previous methods including those based on supervised learning.
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Affiliation(s)
- Muhammad Asaduddin
- Department of Bio and Brain Engineering, Korea Advanced Institute of Science and Technology, Daejeon, South Korea
| | - Eung Yeop Kim
- Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Sung-Hong Park
- Department of Bio and Brain Engineering, Korea Advanced Institute of Science and Technology, Daejeon, South Korea
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Liu MM, Saadat N, Roth SP, Niekrasz MA, Giurcanu M, Carroll TJ, Christoforidis GA. Quantification of Collateral Supply with Local-AIF Dynamic Susceptibility Contrast MRI Predicts Infarct Growth. ARXIV 2024:arXiv:2406.04026v1. [PMID: 38883243 PMCID: PMC11177949] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/18/2024]
Abstract
Background and purpose In ischemic stroke, leptomeningeal collaterals can provide compensatory blood flow to tissue at risk despite an occlusion, and impact treatment response and infarct growth. The purpose of this work is to test the hypothesis that local perfusion with an appropriate Local Arterial Input Function (AIF) is needed to quantify the degree of collateral blood supply in tissue distal to an occlusion. Materials and methods Seven experiments were conducted in a pre-clinical middle cerebral artery occlusion model. Magnetic resonance dynamic susceptibility contrast (DSC) was imaged and post-processed as cerebral blood flow maps with both a traditionally chosen single arterial input function (AIF) applied globally to the whole brain (i.e. "Global-AIF") and a novel automatic delay and dispersion corrected AIF (i.e. "Local AIF") that is sensitive to retrograde flow. Pial collateral recruitment was assessed from x-ray angiograms and infarct growth via serially acquired diffusion weighted MRI scans both blinded to DSC. Results The degree of collateralization at x-ray correlated strongly with quantitative perfusion determined using the Local AIF in the ischemic penumbra (R2=0.81) compared to a traditionally chosen Global-AIF (R2=0.05). Quantitative perfusion calculated using a Local-AIF was negatively correlated (less infarct progression as local perfusion increased) with infarct growth (R2 = 0.79) compared to Global-AIF (R2=0.02). Conclusions Local DSC perfusion with a Local-AIF is more accurate for assessing tissue status and degree of leptomeningeal collateralization than traditionally chosen AIFs. These findings support use of a Local-AIF in determining quantitative tissue perfusion with collateral supply in occlusive disease.
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Affiliation(s)
- Mira M. Liu
- Department of Radiology Medical Physics, University of Chicago, Chicago, IL, USA
- Current affiliation: Biomedical Engineering and Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Niloufar Saadat
- Department of Interventional Radiology, University of Chicago, Chicago, IL, USA
| | - Steven P. Roth
- Department of Anesthesiology, University of Illinois, Chicago, IL, USA
| | - Marek A. Niekrasz
- Department of Surgery and Large Animal Studies, University of Chicago, Chicago, IL, USA
| | - Mihai Giurcanu
- Department of Statistics, University of Chicago, Chicago, IL, USA
| | - Timothy J. Carroll
- Department of Radiology Medical Physics, University of Chicago, Chicago, IL, USA
| | - Gregory A. Christoforidis
- Department of Interventional Radiology, University of Chicago, Chicago, IL, USA
- Current affiliation: Mount Carmel Health Systems, Columbus, OH, USA
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Liu M, Saadat N, Jeong YI, Roth S, Niekrasz M, Carroll T, Christoforidis GA. Augmentation of perfusion with simultaneous vasodilator and inotropic agents in experimental acute middle cerebral artery occlusion: a pilot study. J Neurointerv Surg 2023; 15:e69-e75. [PMID: 35803730 DOI: 10.1136/jnis-2022-018990] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Accepted: 06/23/2022] [Indexed: 11/04/2022]
Abstract
BACKGROUND This study tests the hypothesis that simultaneous cerebral blood pressure elevation and potent vasodilation augments perfusion to ischemic tissue in acute ischemic stroke and it varies by degree of pial collateral recruitment. METHODS Fifteen mongrel canines were included. Subjects underwent permanent middle cerebral artery occlusion; pial collateral recruitment was scored before treatment. Seven treatment subjects received a continuous infusion of norepinephrine (0.1-1.52 µg/kg/min; titrated 25-45 mmHg above baseline mean arterial pressure while keeping systolic blood pressure below 180 mmHg) and hydralazine (20 mg) starting 30 min post-occlusion. Perfusion (cerebral blood flow-CBF) was evaluated with quantitative dynamic susceptibility contrast MRI 2.5 hours post-occlusion to produce images in mL/100 g/min, and relative CBF measured as ratios. Mean region of interest (ROI) values were reported, and compared and subject to regression analysis to elucidate trends. RESULTS Differences in quantitative CBF (qCBF) between treatment and control group varied by degree of pial collateral recruitment, based on Wilcoxon rank sum scores and regression model fit. For poorly collateralized subjects, ipsilateral anatomic, core infarct, and penumbra regions showed treatment with higher qCBF, raised above the ischemic threshold, compared with the control, while well collateralized subjects showed a paradoxical decrease maintained above the ischemic threshold for neuronal death. qCBF on the contralateral side increased regardless of collateralization. CONCLUSION Results suggest that perfusion can be augmented in ischemic stroke with norepinephrine and hydralazine. Perfusion augmentation depends on degree of collateralization and territory in question, with some evidence of vascular steal.
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Affiliation(s)
- Mira Liu
- University of Chicago Department of Radiology, Chicago, Illinois, USA
| | - Niloufar Saadat
- University of Chicago Department of Radiology, Chicago, Illinois, USA
| | - Yong Ik Jeong
- University of Chicago Department of Radiology, Chicago, Illinois, USA
| | - Steven Roth
- Anesthesiology, University of Illinois at Chicago, Chicago, Illinois, USA
| | - Marek Niekrasz
- Animal Research Center, The University of Chicago Medicine, Chicago, Illinois, USA
| | - Timothy Carroll
- University of Chicago Department of Radiology, Chicago, Illinois, USA
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Ganeshkumar A, Kale A, Sharma R, Borkar S. Letter to the Editor Regarding "Cerebral Perfusion and Functional Outcome in Pediatric Head Injury Patients". World Neurosurg 2023; 170:264. [PMID: 36096383 DOI: 10.1016/j.wneu.2022.09.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Accepted: 09/02/2022] [Indexed: 11/26/2022]
Affiliation(s)
- Akshay Ganeshkumar
- Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi, India
| | - Ameya Kale
- Kasturba Medical College, Manipal, India
| | - Ravi Sharma
- Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi, India
| | - Sachin Borkar
- Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi, India.
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Ma X, Wang Y, Wang M, Zhang M, Meng N, Zhang L, Zhang J, Dou S, Wang M. Evaluation of infarct core and ischemic penumbra by absolute quantitative cerebral dynamic susceptibility contrast perfusion magnetic resonance imaging using self-calibrated echo planar imaging sequencing in patients with acute ischemic stroke. Quant Imaging Med Surg 2022; 12:4286-4295. [PMID: 35919056 PMCID: PMC9338368 DOI: 10.21037/qims-21-975] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Accepted: 04/02/2022] [Indexed: 11/06/2022]
Abstract
Background It has been hypothesized that an absolute quantitative dynamic susceptibility contrast (DSC) cerebral perfusion-weighted imaging (PWI) technique based on self-calibrated echo-planar imaging (EPI) could be a reliable measurement of quantitative cerebral blood flow (qCBF) and quantitative cerebral blood volume (qCBV). This study aimed to investigate the clinical value of this technique in offering a unique insight into ischemic stroke (IS) pathophysiology and improving the sensitivity of IS diagnosis. Methods A total of 14 patients with IS who underwent routine magnetic resonance imaging (MRI) and Self-CALibrated EPI Perfusion-Weighted Imaging (SCALE-PWI) scanning were prospectively recruited as a consecutive convenience sample. qCBF and qCBV maps were processed immediately online after the scan. Then, 2 radiologists independently drew the region of interest (ROI) of the infarct core, ischemic penumbra, and the contralateral normal tissues on each map for the statistical analyses. The paired-samples t-test, Wilcoxon signed-rank test, independent-samples t-test, and receiver operating characteristic (ROC) curve were performed. A value of P<0.05 was considered statistically significant with 95% confidence intervals (CI). Results All the values of qCBF and qCBV in the lesions were lower than those in the contralateral normal tissues (all P<0.05). The values of qCBF and qCBV in the infarct core were lower than those in the ischemic penumbra (mean values: 16.42 vs. 21.54 mL/100 g/min, P=0.013; 1.23 vs. 1.47 mL/100 g, P=0.049, respectively). The qCBF threshold of the infarct core was 18.18 mL/100 g/min (sensitivity, 71.40%; specificity, 64.30%) and the qCBF threshold of the ischemic penumbra was 28.09 mL/100 g/min (sensitivity, 78.60%; specificity, 85.70%). Conclusions Different from the previous semi-quantitative measurement, the SCALE-PWI technique has the potential to provide absolute quantitative hemodynamic information which may be used to detect the infarct core and ischemic penumbra in a relatively short scan time.
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Affiliation(s)
- Xiaoyue Ma
- Department of Magnetic Resonance Imaging, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Yan Wang
- Department of Radiology, Zhengzhou University People's Hospital, Zhengzhou, China
| | - Mengke Wang
- Department of Radiology, Zhengzhou University People's Hospital, Zhengzhou, China
| | - Menghuan Zhang
- Department of Radiology, Zhengzhou University People's Hospital, Zhengzhou, China
| | - Nan Meng
- Department of Radiology, Zhengzhou University People's Hospital, Zhengzhou, China
| | - Long Zhang
- Department of Neurology, Zhengzhou University People's Hospital, Zhengzhou, China
| | - Jinlong Zhang
- Department of Neurology, Zhengzhou University People's Hospital, Zhengzhou, China
| | - Shewei Dou
- Department of Radiology, Zhengzhou University People's Hospital, Zhengzhou, China
| | - Meiyun Wang
- Department of Radiology, Zhengzhou University People's Hospital, Zhengzhou, China
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Dimov AV, Christoforidis GA, Saadat N, Liu MM, Jeong YI, Roth S, Niekrasz M, Carroll TJ. QSM in canine model of acute cerebral ischemia: A pilot study. Magn Reson Med 2021; 85:1602-1610. [PMID: 33034078 DOI: 10.1002/mrm.28498] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Revised: 06/28/2020] [Accepted: 08/05/2020] [Indexed: 11/07/2022]
Abstract
PURPOSE In the present study, we investigated the potential of QSM to assess the physiological state of cortical tissue in the middle cerebral artery occlusion canine model of a cerebral ischemia. METHODS Experiments were performed in 8 anesthetized canines. Gradient echo, perfusion, and DWI data of brains at normal and ischemic states were acquired. In the postprocessed susceptibility and quantitative cerebral blood flow maps, changes in values within the middle cerebral artery-fed cortical territories were quantified both on the ischemic and normal contralateral hemisphere side. RESULTS QSM values in critically ischemic tissue were significantly different from contralateral values-namely, susceptibility increase was observed in the cases in which cerebral perfusion was maintained above the threshold of neuronal death. Furthermore, the data indicates presence of a significant correlation between the changes in susceptibility values, cerebral perfusion, and the infarct volume and pial collateral scores. Additionally, our data suggests that difference in cortical susceptibility is prospectively indicative of the infarct growth rate. CONCLUSION In an experimental permanent middle cerebral artery occlusion model, QSM was shown to correlate with the functional parameters characterizing viability of ischemic tissue, thus warranting further research on its ability to provide complementary information during acute stroke MRI examinations in humans.
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Affiliation(s)
- Alexey V Dimov
- Department of Radiology, University of Chicago, Chicago, Illinois, USA
| | | | - Niloufar Saadat
- Department of Radiology, University of Chicago, Chicago, Illinois, USA
| | - Mira M Liu
- Department of Radiology, University of Chicago, Chicago, Illinois, USA
| | - Yong I Jeong
- Department of Radiology, University of Chicago, Chicago, Illinois, USA
| | - Steven Roth
- Department of Anesthesiology, University of Illinois, College of Medicine, Chicago, Illinois, USA
| | - Marek Niekrasz
- Department of Surgery, University of Chicago, Chicago, Illinois, USA
| | - Timothy J Carroll
- Department of Radiology, University of Chicago, Chicago, Illinois, USA
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McDonough R, Elsayed S, Faizy TD, Austein F, Sporns PB, Meyer L, Bechstein M, van Horn N, Nawka MT, Schön G, Kniep H, Hanning U, Fiehler J, Heit JJ, Broocks G. Computed tomography-based triage of extensive baseline infarction: ASPECTS and collaterals versus perfusion imaging for outcome prediction. J Neurointerv Surg 2020; 13:869-874. [PMID: 33168659 DOI: 10.1136/neurintsurg-2020-016848] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Revised: 10/09/2020] [Accepted: 10/14/2020] [Indexed: 12/28/2022]
Abstract
BACKGROUND Patients presenting with large baseline infarctions are often excluded from mechanical thrombectomy (MT) due to uncertainty surrounding its effect on outcome. We hypothesized that computed tomography perfusion (CTP)-based selection may be predictive of functional outcome in low Alberta Stroke Program Early CT Score (ASPECTS) patients. METHODS This was a double-center, retrospective analysis of patients presenting with ASPECTS≤5 who received multimodal admission CT imaging between May 2015 and June 2020. The predicted ischemic core (pCore) was defined as a reduction in cerebral blood flow (rCBF), while mismatch volume was defined using time to maximum (Tmax). The pCore perfusion mismatch ratio (CPMR) was also calculated. These parameters (pCore, mismatch volume, and CPMR), as well as a combined radiological score consisting of ASPECTS and collateral status (ASCO score), were tested in logistic regression and receiver operating characteristic (ROC) analyses. The primary outcome was favorable modified Rankin Scale (mRS) at discharge (≤3). RESULTS A total of 113 patients met the inclusion criteria. The median ischemic core volume was 74.1 mL (IQR 43.8-121.8). The ASCO score was associated with favorable outcome at discharge (aOR 3.7, 95% CI 1.8 to 10.7, P=0.002), while no association was observed for the CTP parameters. A model including the ASCO score also had significantly higher area under the curve (AUC) values compared with the CTP-based model (0.88 vs 0.64, P=0.018). CONCLUSIONS The ASCO score was superior to the CTP-based model for the prediction of good functional outcome and could represent a quick, practical, and easily implemented method for the selection of low ASPECTS patients most likely benefit from MT.
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Affiliation(s)
- Rosalie McDonough
- Department of Diagnostic and Interventional Neuroradiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Sarah Elsayed
- Department of Diagnostic and Interventional Neuroradiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | | | - Friederike Austein
- Department of Diagnostic and Interventional Neuroradiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Peter B Sporns
- Department of Neuroradiology, University Hospital Basel, Basel, Switzerland
| | - Lukas Meyer
- Department of Diagnostic and Interventional Neuroradiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Matthias Bechstein
- Department of Diagnostic and Interventional Neuroradiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Noel van Horn
- Department of Diagnostic and Interventional Neuroradiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Marie Teresa Nawka
- Department of Diagnostic and Interventional Neuroradiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Gerhard Schön
- Institute of Medical Biometry and Epidemiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Helge Kniep
- Department of Diagnostic and Interventional Neuroradiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Uta Hanning
- Department of Diagnostic and Interventional Neuroradiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Jens Fiehler
- Department of Diagnostic and Interventional Neuroradiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Jeremy J Heit
- Radiology, Neuroradiology and Neurointervention Division, Stanford University, Stanford, California, USA
| | - Gabriel Broocks
- Department of Diagnostic and Interventional Neuroradiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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Asaduddin M, Do WJ, Kim EY, Park SH. Mapping cerebral perfusion from time-resolved contrast-enhanced MR angiographic data. Magn Reson Imaging 2019; 61:143-148. [DOI: 10.1016/j.mri.2019.05.040] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2019] [Revised: 05/24/2019] [Accepted: 05/27/2019] [Indexed: 12/23/2022]
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Neal MA, Pippard BJ, Simpson AJ, Thelwall PE. Dynamic susceptibility contrast 19 F-MRI of inhaled perfluoropropane: a novel approach to combined pulmonary ventilation and perfusion imaging. Magn Reson Med 2019; 83:452-461. [PMID: 31468589 PMCID: PMC6899496 DOI: 10.1002/mrm.27933] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2019] [Revised: 07/12/2019] [Accepted: 07/16/2019] [Indexed: 12/19/2022]
Abstract
PURPOSE To assess alveolar perfusion by applying dynamic susceptibility contrast MRI to 19 F-MRI of inhaled perfluoropropane (PFP). We hypothesized that passage of gadolinium-based contrast agent (GBCA) through the pulmonary microvasculature would reduce magnetic susceptibility differences between water and gas components of the lung, elevating the T 2 ∗ of PFP. METHODS Lung-representative phantoms were constructed of aqueous PFP-filled foams to characterize the impact of aqueous/gas phase magnetic susceptibility differences on PFP T 2 ∗ . Aqueous phase magnetic susceptibility was modulated by addition of different concentrations of GBCA. In vivo studies were performed to measure the impact of intravenously administered GBCA on the T 2 ∗ of inhaled PFP in mice (7.0 Tesla) and in healthy volunteers (3.0 Tesla). RESULTS Perfluoropropane T 2 ∗ was sensitive to modulation of magnetic susceptibility difference between gas and water components of the lung, both in phantom models and in vivo. Negation of aqueous/gas phase magnetic susceptibility difference was achieved in lung-representative phantoms and in mice, resulting in a ~2 to 3× elevation in PFP T 2 ∗ (3.7 to 8.5 ms and 0.7 to 2.6 ms, respectively). Human studies demonstrated a transient elevation of inhaled PFP T 2 ∗ (1.50 to 1.64 ms) during passage of GBCA bolus through the lung circulation, demonstrating sensitivity to lung perfusion. CONCLUSION We demonstrate indirect detection of a GBCA in the pulmonary microvasculature via changes to the T 2 ∗ of gas phase PFP within directly adjacent alveoli. This approach holds potential for assessing alveolar perfusion by dynamic susceptibility contrast 19 F-MRI of inhaled PFP, with concurrent assessment of lung ventilation properties, relevant to lung physiology and disease.
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Affiliation(s)
- Mary A Neal
- Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, United Kingdom.,Newcastle Magnetic Resonance Centre, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Benjamin J Pippard
- Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, United Kingdom.,Newcastle Magnetic Resonance Centre, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - A John Simpson
- Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, United Kingdom.,Respiratory Medicine, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, United Kingdom
| | - Peter E Thelwall
- Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, United Kingdom.,Newcastle Magnetic Resonance Centre, Newcastle University, Newcastle upon Tyne, United Kingdom
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Juan-Albarracín J, Fuster-Garcia E, García-Ferrando GA, García-Gómez JM. ONCOhabitats: A system for glioblastoma heterogeneity assessment through MRI. Int J Med Inform 2019; 128:53-61. [DOI: 10.1016/j.ijmedinf.2019.05.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2018] [Revised: 04/30/2019] [Accepted: 05/05/2019] [Indexed: 01/19/2023]
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Juan-Albarracín J, Fuster-Garcia E, Pérez-Girbés A, Aparici-Robles F, Alberich-Bayarri Á, Revert-Ventura A, Martí-Bonmatí L, García-Gómez JM. Glioblastoma: Vascular Habitats Detected at Preoperative Dynamic Susceptibility-weighted Contrast-enhanced Perfusion MR Imaging Predict Survival. Radiology 2018; 287:944-954. [DOI: 10.1148/radiol.2017170845] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Affiliation(s)
- Javier Juan-Albarracín
- From the Instituto Universitario de Aplicaciones de las Tecnologías de la Información y de las Comunicaciones Avanzadas, Universitat Politècnica de València, Camino de Vera s/n, 46022 Valencia, Spain
| | - Elies Fuster-Garcia
- From the Instituto Universitario de Aplicaciones de las Tecnologías de la Información y de las Comunicaciones Avanzadas, Universitat Politècnica de València, Camino de Vera s/n, 46022 Valencia, Spain
| | - Alexandre Pérez-Girbés
- From the Instituto Universitario de Aplicaciones de las Tecnologías de la Información y de las Comunicaciones Avanzadas, Universitat Politècnica de València, Camino de Vera s/n, 46022 Valencia, Spain
| | - Fernando Aparici-Robles
- From the Instituto Universitario de Aplicaciones de las Tecnologías de la Información y de las Comunicaciones Avanzadas, Universitat Politècnica de València, Camino de Vera s/n, 46022 Valencia, Spain
| | - Ángel Alberich-Bayarri
- From the Instituto Universitario de Aplicaciones de las Tecnologías de la Información y de las Comunicaciones Avanzadas, Universitat Politècnica de València, Camino de Vera s/n, 46022 Valencia, Spain
| | - Antonio Revert-Ventura
- From the Instituto Universitario de Aplicaciones de las Tecnologías de la Información y de las Comunicaciones Avanzadas, Universitat Politècnica de València, Camino de Vera s/n, 46022 Valencia, Spain
| | - Luis Martí-Bonmatí
- From the Instituto Universitario de Aplicaciones de las Tecnologías de la Información y de las Comunicaciones Avanzadas, Universitat Politècnica de València, Camino de Vera s/n, 46022 Valencia, Spain
| | - Juan M. García-Gómez
- From the Instituto Universitario de Aplicaciones de las Tecnologías de la Información y de las Comunicaciones Avanzadas, Universitat Politècnica de València, Camino de Vera s/n, 46022 Valencia, Spain
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12
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Mulholland AD, Vitorino R, Hojjat SP, Ma AY, Zhang L, Lee L, Carroll TJ, Cantrell CG, Figley CR, Aviv RI. Spatial Correlation of Pathology and Perfusion Changes within the Cortex and White Matter in Multiple Sclerosis. AJNR Am J Neuroradiol 2017; 39:91-96. [PMID: 29097413 DOI: 10.3174/ajnr.a5410] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2016] [Accepted: 08/04/2017] [Indexed: 12/18/2022]
Abstract
BACKGROUND AND PURPOSE The spatial correlation between WM and cortical GM disease in multiple sclerosis is controversial and has not been previously assessed with perfusion MR imaging. We sought to determine the nature of association between lobar WM, cortical GM, volume and perfusion. MATERIALS AND METHODS Nineteen individuals with secondary-progressive multiple sclerosis, 19 with relapsing-remitting multiple sclerosis, and 19 age-matched healthy controls were recruited. Quantitative MR perfusion imaging was used to derive CBF, CBV, and MTT within cortical GM, WM, and T2-hyperintense lesions. A 2-step multivariate linear regression (corrected for age, disease duration, and Expanded Disability Status Scale) was used to assess correlations between perfusion and volume measures in global and lobar normal-appearing WM, cortical GM, and T2-hyperintense lesions. The Bonferroni adjustment was applied as appropriate. RESULTS Global cortical GM and WM volume was significantly reduced for each group comparison, except cortical GM volume of those with relapsing-remitting multiple sclerosis versus controls. Global and lobar cortical GM CBF and CBV were reduced in secondary-progressive multiple sclerosis compared with other groups but not for relapsing-remitting multiple sclerosis versus controls. Global and lobar WM CBF and CBV were not significantly different across groups. The distribution of lobar cortical GM and WM volume reduction was disparate, except for the occipital lobes in patients with secondary-progressive multiple sclerosis versus those with relapsing-remitting multiple sclerosis. Moderate associations were identified between lobar cortical GM and lobar normal-appearing WM volume in controls and in the left temporal lobe in relapsing-remitting multiple sclerosis. No significant associations occurred between cortical GM and WM perfusion or volume. Strong correlations were observed between cortical-GM perfusion, normal appearing WM and lesional perfusion, with respect to each global and lobar region within HC, and RRMS and SPMS patients (R2 ≤ 0.96, P < .006 and R2 ≤ 0.738, P < .006). CONCLUSIONS The weak correlation between lobar WM and cortical GM volume loss and perfusion reduction suggests the independent pathophysiology of WM and cortical GM disease.
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Affiliation(s)
- A D Mulholland
- From the Department of Physical Sciences (A.D.M., R.V., S.-P.H., A.Y.M., L.Z.), Sunnybrook Research Institute, Toronto, Ontario, Canada
| | - R Vitorino
- From the Department of Physical Sciences (A.D.M., R.V., S.-P.H., A.Y.M., L.Z.), Sunnybrook Research Institute, Toronto, Ontario, Canada
| | - S-P Hojjat
- From the Department of Physical Sciences (A.D.M., R.V., S.-P.H., A.Y.M., L.Z.), Sunnybrook Research Institute, Toronto, Ontario, Canada
| | - A Y Ma
- From the Department of Physical Sciences (A.D.M., R.V., S.-P.H., A.Y.M., L.Z.), Sunnybrook Research Institute, Toronto, Ontario, Canada
| | - L Zhang
- From the Department of Physical Sciences (A.D.M., R.V., S.-P.H., A.Y.M., L.Z.), Sunnybrook Research Institute, Toronto, Ontario, Canada.,Departments of Medical Imaging (L.Z., R.I.A.)
| | - L Lee
- Neurology (L.L.), Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
| | - T J Carroll
- Department of Biomedical Engineering and Radiology (T.J.C.), University of Chicago, Chicago, Illinois
| | - C G Cantrell
- Department of Biomedical Engineering (C.G.C.), Northwestern University, Chicago, Illinois
| | - C R Figley
- Department of Radiology and Biomedical Engineering (C.R.F.), University of Manitoba, Winnipeg, Manitoba, Canada
| | - R I Aviv
- Departments of Medical Imaging (L.Z., R.I.A.) .,Department of Medical Imaging (R.I.A.), University of Toronto, Toronto, Ontario, Canada
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13
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Heiss WD, Zaro Weber O. Validation of MRI Determination of the Penumbra by PET Measurements in Ischemic Stroke. J Nucl Med 2016; 58:187-193. [PMID: 27879370 DOI: 10.2967/jnumed.116.185975] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2016] [Accepted: 11/10/2016] [Indexed: 11/16/2022] Open
Abstract
The concept of the ischemic penumbra was formulated on the basis of animal experiments showing functional impairment and electrophysiologic disturbances with decreasing flow to the brain below defined values (the threshold for function) and irreversible tissue damage with blood supply further decreased (the threshold for infarction). The perfusion range between these thresholds was termed the "penumbra," and restitution of flow above the functional threshold was able to reverse the deficits without permanent damage. In further experiments, the dependency of the development of irreversible lesions on the interaction of the severity and the duration of critically reduced blood flow was established, proving that the lower the flow, the shorter the time for efficient reperfusion. As a consequence, infarction develops from the core of ischemia to the areas of less severe hypoperfusion. The translation of this experimental concept as the basis for the efficient treatment of stroke requires noninvasive methods with which regional flow and energy metabolism can be repeatedly investigated to demonstrate penumbra tissue, which can benefit from therapeutic interventions. PET allows the quantification of regional cerebral blood flow, the regional oxygen extraction fraction, and the regional metabolic rate for oxygen. With these variables, clear definitions of irreversible tissue damage and of critically hypoperfused but potentially salvageable tissue (i.e., the penumbra) in stroke patients can be achieved. However, PET is a research tool, and its complex logistics limit clinical routine applications. Perfusion-weighted or diffusion-weighted MRI is a widely applicable clinical tool, and the "mismatch" between perfusion-weighted and diffusion-weighted abnormalities serves as an indicator of the penumbra. However, comparative studies of perfusion-weighted or diffusion-weighted MRI and PET have indicated overestimation of the core of irreversible infarction as well as of the penumbra by the MRI modalities. Some of these discrepancies can be explained by the nonselective application of relative perfusion thresholds, which might be improved by more complex analytic procedures. The heterogeneity of the MRI signatures used for the definition of the mismatch are also responsible for disappointing results in the application of perfusion-weighted or diffusion-weighted MRI to the selection of patients for clinical trials. As long as validation of the mismatch selection paradigm is lacking, the use of this paradigm as a surrogate marker of outcome is limited.
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Vitorino R, Hojjat SP, Cantrell CG, Feinstein A, Zhang L, Lee L, O'Connor P, Carroll TJ, Aviv RI. Regional Frontal Perfusion Deficits in Relapsing-Remitting Multiple Sclerosis with Cognitive Decline. AJNR Am J Neuroradiol 2016; 37:1800-1807. [PMID: 27197989 DOI: 10.3174/ajnr.a4824] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2016] [Accepted: 03/17/2016] [Indexed: 12/23/2022]
Abstract
BACKGROUND AND PURPOSE Cortical dysfunction, quantifiable by cerebral perfusion techniques, is prevalent in patients with MS, contributing to cognitive impairment. We sought to localize perfusion distribution differences in patients with relapsing-remitting MS with and without cognitive impairment and healthy controls. MATERIALS AND METHODS Thirty-nine patients with relapsing-remitting MS (20 cognitively impaired, 19 nonimpaired) and 19 age- and sex-matched healthy controls underwent a neurocognitive battery and MR imaging. Voxel-based analysis compared regional deep and cortical GM perfusion and volume among the cohorts. RESULTS After we adjusted for localized volumetric differences in the right frontal, temporal, and occipital lobes, progressive CBF and CBV deficits were present in the left middle frontal cortex for all cohorts and in the left superior frontal gyrus for patients with cognitive impairment compared with patients without impairment and controls. Compared with healthy controls, reduced CBF was present in the limbic regions of patients with cognitive impairment, and reduced CBV was present in the right middle frontal gyrus in patients with cognitive impairment and in the temporal gyrus of relapsing-remitting MS patients without cognitive impairment. CONCLUSIONS Consistent regional frontal cortical perfusion deficits are present in patients with relapsing-remitting MS, with more widespread hypoperfusion in those with cognitive impairment, independent of structural differences, indicating that cortical perfusion may be a useful biomarker of cortical dysfunction and cognitive impairment in MS.
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Affiliation(s)
- R Vitorino
- Medical Imaging (R.V., S.-P.H., L.Z., R.I.A.), Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
| | - S-P Hojjat
- Medical Imaging (R.V., S.-P.H., L.Z., R.I.A.), Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
- Medical Imaging (S.-P.H., R.I.A.), University of Toronto, Toronto, Ontario, Canada
| | - C G Cantrell
- Departments of Biomedical Engineering (C.G.C., T.J.C)
| | - A Feinstein
- From the Departments of Psychiatry (A.F.)
- Psychiatry (A.F.)
| | - L Zhang
- Medical Imaging (R.V., S.-P.H., L.Z., R.I.A.), Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
| | - L Lee
- Neurology (L.L.)
- Departments of Medicine (L.L., P.O.)
| | | | - T J Carroll
- Departments of Biomedical Engineering (C.G.C., T.J.C)
- Radiology (T.J.C.), Northwestern University, Chicago, Illinois
| | - R I Aviv
- Medical Imaging (R.V., S.-P.H., L.Z., R.I.A.), Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
- Medical Imaging (S.-P.H., R.I.A.), University of Toronto, Toronto, Ontario, Canada
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15
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Hojjat SP, Kincal M, Vitorino R, Cantrell CG, Feinstein A, Zhang L, Lee L, O'Connor P, Carroll TJ, Aviv RI. Cortical Perfusion Alteration in Normal-Appearing Gray Matter Is Most Sensitive to Disease Progression in Relapsing-Remitting Multiple Sclerosis. AJNR Am J Neuroradiol 2016; 37:1454-61. [PMID: 27012299 DOI: 10.3174/ajnr.a4737] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2015] [Accepted: 01/12/2016] [Indexed: 01/03/2023]
Abstract
BACKGROUND AND PURPOSE The role of gray matter in multiple sclerosis is increasingly evident; however, conventional images demonstrate limitations in cortical lesion identification. Perfusion imaging appears sensitive to changes in tissue type and disease severity in MS. We sought to use bookend perfusion to quantify parameters in healthy controls and normal-appearing and lesional tissue at different relapsing-remitting MS stages. MATERIALS AND METHODS Thirty-nine patients with relapsing-remitting MS and 19 age-matched healthy controls were prospectively recruited. The Minimal Assessment of Cognitive Function in MS battery was used to assess cognitive performance. Perfusion parameters, including cerebral blood flow and volume and mean transit time, were compared for healthy controls and normal-appearing and lesional tissue for all study groups. Dispersion of perfusion measures for white matter lesions and cortical lesions was assessed. RESULTS Twenty of the 39 patients with relapsing-remitting MS were cognitively impaired. Significant differences were displayed between all relapsing-remitting MS subgroups and healthy controls in all comparisons except for normal-appearing gray matter CBV between healthy controls and unimpaired patients with relapsing-remitting MS and for all normal-appearing white matter perfusion parameters between healthy controls and unimpaired patients with relapsing-remitting MS. White matter lesion but not cortical lesion perfusion was significantly reduced in cognitively impaired patients with relapsing-remitting MS versus unimpaired patients with relapsing-remitting MS. Perfusion reduction with disease progression was greater in normal-appearing gray matter and normal-appearing white matter compared with cortical lesions and white matter lesions. Smaller dispersion was observed for cortical lesions compared with white matter lesions for each perfusion parameter. CONCLUSIONS Quantitative GM and WM analysis demonstrated significant but disproportionate white matter lesion, cortical lesion, normal-appearing white matter, and normal-appearing gray matter changes present between healthy controls and patients with relapsing-remitting MS with and without cognitive impairment, necessitating absolute rather than relative lesion perfusion measurement.
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Affiliation(s)
- S-P Hojjat
- Medical Imaging (S.-P.H., M.K., R.V., R.I.A., L.Z.), Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada Medical Imaging (S.-P.H., R.I.A.), University of Toronto, Toronto, Ontario, Canada
| | - M Kincal
- Medical Imaging (S.-P.H., M.K., R.V., R.I.A., L.Z.), Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
| | - R Vitorino
- Medical Imaging (S.-P.H., M.K., R.V., R.I.A., L.Z.), Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
| | - C G Cantrell
- Departments of Biomedical Engineering (C.G.C., T.J.C.)
| | - A Feinstein
- From the Departments of Psychiatry (A.F.) Psychiatry (A.F.)
| | - L Zhang
- Medical Imaging (S.-P.H., M.K., R.V., R.I.A., L.Z.), Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
| | - L Lee
- Neurology (L.L.) Departments of Medicine (P.O., L.L.)
| | | | - T J Carroll
- Departments of Biomedical Engineering (C.G.C., T.J.C.) Radiology (T.J.C.), Northwestern University, Chicago, Illinois
| | - R I Aviv
- Medical Imaging (S.-P.H., M.K., R.V., R.I.A., L.Z.), Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada Medical Imaging (S.-P.H., R.I.A.), University of Toronto, Toronto, Ontario, Canada
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16
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Gawlitza M, Friedrich B, Hobohm C, Schaudinn A, Schob S, Quäschling U, Hoffmann KT, Lobsien D. Distance to Thrombus in Acute Middle Cerebral Artery Occlusion Predicts Target Mismatch and Ischemic Penumbra. J Stroke Cerebrovasc Dis 2015; 25:298-305. [PMID: 26542822 DOI: 10.1016/j.jstrokecerebrovasdis.2015.09.032] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2015] [Revised: 09/11/2015] [Accepted: 09/26/2015] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND AND PURPOSE In patients with occlusion of the middle cerebral artery (MCA) treated by intravenous thrombolysis (IVT), the distance to thrombus (DT) has been proposed as a predictor of outcome. The purpose of the present study was to investigate how DT relates to dynamic susceptibility contrast perfusion metrics. METHODS Retrospective analysis was undertaken of patients who were diagnosed with acute MCA occlusion by magnetic resonance imaging and treated with IVT. Volumes of time-to-maximum (Tmax) perfusion deficits and diffusion-weighted imaging (DWI) lesions, diffusion-perfusion mismatch volumes, and the presence of target mismatch were determined. Correlations between the above stoke measures and DT were then calculated. RESULTS Fifty-five patients were included. DT showed significant inverse correlations with Tmax greater than 4, 6, 8, and 10 seconds, respectively, and mismatch volumes. Using the DT group median (14 mm) as a separator, significant intergroup differences were observed for Tmax greater than 4, 6, and 8 seconds, respectively, and for mismatch volumes. Grouping DT into quartiles showed significant intergroup differences regarding mismatch volumes and Tmax values greater than 4 and 6 seconds. Binary logistic regression identified DT (odds ratio [OR] = .89; 95% confidence interval [CI], .81-.99) and DWI lesion volumes (OR = .92; 95% CI, .86-.97) as independent predictors of target mismatch. A low DT predicted target mismatch with an area under the curve of .69. CONCLUSIONS DT correlates inversely with Tmax perfusion deficits and mismatch volumes and acts as an independent predictor of target mismatch.
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Affiliation(s)
- Matthias Gawlitza
- Department of Neuroradiology, University Hospital Leipzig, Leipzig, Germany.
| | - Benjamin Friedrich
- Department of Diagnostic and Interventional Radiology, University Hospital Leipzig, Leipzig, Germany
| | - Carsten Hobohm
- Department of Neurology, University Hospital Leipzig, Leipzig, Germany
| | - Alexander Schaudinn
- Department of Diagnostic and Interventional Radiology, University Hospital Leipzig, Leipzig, Germany
| | - Stefan Schob
- Department of Neuroradiology, University Hospital Leipzig, Leipzig, Germany
| | - Ulf Quäschling
- Department of Neuroradiology, University Hospital Leipzig, Leipzig, Germany
| | | | - Donald Lobsien
- Department of Neuroradiology, University Hospital Leipzig, Leipzig, Germany
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17
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Ford AL, An H, Kong L, Zhu H, Vo KD, Powers WJ, Lin W, Lee JM. Clinically relevant reperfusion in acute ischemic stroke: MTT performs better than Tmax and TTP. Transl Stroke Res 2014; 5:415-421. [PMID: 24500786 DOI: 10.1007/s12975-014-0325-2] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2013] [Revised: 12/11/2013] [Accepted: 01/05/2014] [Indexed: 10/25/2022]
Abstract
While several MRI parameters are used to assess tissue perfusion during hyperacute stroke, it is unclear which is optimal for measuring clinically relevant reperfusion. We directly compared mean transit time (MTT) prolongation (MTTp), time-to-peak (TTP), and time-to-maximum (Tmax) to determine which best predicted neurological improvement and tissue salvage following early reperfusion. Acute ischemic stroke patients underwent three MRIs: <4.5 h (tp1), at 6 h (tp2), and at 1 month after onset. Perfusion deficits at tp1 and tp2 were defined by MTTp, TTP, or Tmax beyond four commonly used thresholds. Percent reperfusion (%Reperf) was calculated for each parameter and threshold. Regression analysis was used to fit %Reperf for each parameter and threshold as a predictor of neurological improvement [defined as admission National Institutes of Health Stroke Scale (NIHSS)-1 month NIHSS (∆NIHSS)] after adjusting for baseline clinical variables. Volume of reperfusion, for each parameter and threshold, was correlated with tissue salvage, defined as tp1 perfusion deficit volume-final infarct volume. Fifty patients were scanned at 2.7 and 6.2 h after stroke onset. %Reperf predicted ∆NIHSS for all MTTp thresholds, for Tmax >6 s and >8 s, but for no TTP thresholds. Tissue salvage significantly correlated with reperfusion for all MTTp thresholds and with Tmax >6 s, while there was no correlation with any TTP threshold. Among all parameters, reperfusion defined by MTTp was most strongly associated with ∆NIHSS (MTTp >3 s, P = 0.0002) and tissue salvage (MTTp >3 s and 4 s, P < 0.0001). MTT-defined reperfusion was the best predictor of neurological improvement and tissue salvage in hyperacute ischemic stroke.
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Affiliation(s)
- Andria L Ford
- Department of Neurology, Washington University School of Medicine
| | - Hongyu An
- Department of Radiology, University of North Carolina at Chapel Hill
| | - Linglong Kong
- Department of Mathematical and Statistical Sciences, University of Alberta
| | - Hongtu Zhu
- Department of Biostatistics, University of North Carolina at Chapel Hill
| | - Katie D Vo
- Department of Radiology, Washington University School of Medicine
| | - William J Powers
- Department of Neurology, University of North Carolina at Chapel Hill
| | - Weili Lin
- Department of Radiology, University of North Carolina at Chapel Hill
| | - Jin-Moo Lee
- Department of Neurology, Washington University School of Medicine.,Department of Radiology, Washington University School of Medicine
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18
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Crane DE, Donahue MJ, Chappell MA, Sideso E, Handa A, Kennedy J, Jezzard P, MacIntosh BJ. Evaluating quantitative approaches to dynamic susceptibility contrast MRI among carotid endarterectomy patients. J Magn Reson Imaging 2012; 37:936-43. [PMID: 23097408 DOI: 10.1002/jmri.23882] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2012] [Accepted: 09/13/2012] [Indexed: 11/11/2022] Open
Abstract
PURPOSE To evaluate two dynamic susceptibility contrast (DSC) quantification methods in symptomatic carotid artery disease patients undergoing carotid endarterectomy (CEA) surgery by comparing methods directly and assessing the reliability of each method in the hemisphere contralateral to surgery. MATERIALS AND METHODS Absolute cerebral blood flow (CBF) and volume (CBV) was calculated in putamen and sensorimotor gray matter of 17 patients using two methods: 1) The Bookend method that scales relative DSC images to CBV values calculated from the ratio of pre- and postcontrast T1-weighted images, and 2) the Tail-scaling method that uses the ratio of area under the tails of the venous and arterial concentration time-courses to scale the DSC images. RESULTS There was a positive correlation between the methods with significant correlation post-CEA (P < 0.035). Intersession correlation was greater when using the Tail-scaling method contralateral to surgery (P < 0.004). CONCLUSION We have demonstrated correlation between methods that is significant after surgery and have found that the Tail-scaling method produces better test-retest reliability than our implementation of the Bookend method. Results from this study suggest that DSC has the potential to measure hemodynamic changes after endarterectomy and future work is required to establish clinical value.
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Affiliation(s)
- David E Crane
- Heart and Stroke Foundation Center for Stroke Recovery, Sunnybrook Research Institute, University of Toronto, Toronto, Ontario, Canada
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Ashafaq M, Khan MM, Shadab Raza S, Ahmad A, Khuwaja G, Javed H, Khan A, Islam F, Siddiqui MS, Safhi MM, Islam F. S-allyl cysteine mitigates oxidative damage and improves neurologic deficit in a rat model of focal cerebral ischemia. Nutr Res 2012; 32:133-43. [PMID: 22348462 DOI: 10.1016/j.nutres.2011.12.014] [Citation(s) in RCA: 58] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2011] [Revised: 12/20/2011] [Accepted: 12/30/2011] [Indexed: 01/08/2023]
Abstract
Oxidative stress and inflammatory damage play an important role in cerebral ischemic pathogenesis and may represent a target for treatment. The present study examined the hypothesis that S-allyl cysteine (SAC), organosulfur compounds found in garlic extract, would reduce oxidative stress-associated brain injury after middle cerebral artery occlusion (MCAO). To test this hypothesis, male Wistar rats were subjected to MCAO for 2 hours and 22-hour reperfusion. S-allyl cysteine was administered (100 mg/kg, b.wt.) intraperitoneally 30 minutes before the onset of ischemia and after the ischemia at the interval of 0, 6, and 12 hours. After 24 hours of reperfusion, rats were tested for neurobehavioral activities and were killed for the infarct volume, estimation of lipid peroxidation, glutathione content, and activity of antioxidant enzymes (glutathione peroxidase, glutathione reductase, catalase, and superoxide dismutase). S-allyl cysteine treatment significantly reduced ischemic lesion volume, improved neurologic deficits, combated oxidative loads, and suppressed neuronal loss. Behavioral and biochemical alterations observed after MCAO were further associated with an increase in glial fibrillary acidic protein and inducible nitric oxide expression and were markedly inhibited by the treatment with SAC. The results suggest that SAC exhibits exuberant neuroprotective potential in rat ischemia/reperfusion model. Thus, this finding of SAC-induced adaptation to ischemic stress and inflammation could suggest a novel avenue for clinical intervention during ischemia and reperfusion.
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Affiliation(s)
- Mohammad Ashafaq
- Department of Medical Elementology and Toxicology (Fund for the Improvement of Science and Technology sponsored by DST and Special Assistance Programme sponsored by UGC), JamiaHamdard (Hamdard University), Hamdard Nagar, New Delhi-110062, India
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20
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Edaravone ameliorates oxidative stress associated cholinergic dysfunction and limits apoptotic response following focal cerebral ischemia in rat. Mol Cell Biochem 2012; 367:215-25. [DOI: 10.1007/s11010-012-1335-6] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2012] [Accepted: 05/03/2012] [Indexed: 10/28/2022]
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21
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Liang P, Yang Y, Chen W, Duan Y, Wang H, Wang X. Magnetic resonance perfusion imaging evaluation in perfusion abnormalities of the cerebellum after supratentorial unilateral hyperacute cerebral infarction. Neural Regen Res 2012; 7:906-11. [PMID: 25722674 PMCID: PMC4341285 DOI: 10.3969/j.issn.1673-5374.2012.12.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2011] [Accepted: 03/12/2012] [Indexed: 11/06/2022] Open
Abstract
Magnetic resonance imaging (MRI) data of 10 patients with hyperacute cerebral infarction (≤ 6 hours) were retrospectively analyzed. Six patients exhibited perfusion defects on negative enhancement integral maps, four patients exhibited perfusion differences in pseudo-color on mean time to enhance maps, and three patients exhibited perfusion differences in pseudo-color on time to minimum maps. Dynamic susceptibility contrast-enhanced perfusion weighted imaging revealed a significant increase in region negative enhancement integral in the affected hemisphere of patients with cerebral infarction. The results suggest that dynamic susceptibility contrast-enhanced perfusion weighted imaging can clearly detect perfusion abnormalities in the cerebellum after unilateral hyperacute cerebral infarction.
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Affiliation(s)
- Pan Liang
- Department of Radiology, First Affiliated Hospital of Wenzhou Medical College, Wenzhou 325000, Zhejiang Province, China
| | - Yunjun Yang
- Department of Radiology, First Affiliated Hospital of Wenzhou Medical College, Wenzhou 325000, Zhejiang Province, China
| | - Weijian Chen
- Department of Radiology, First Affiliated Hospital of Wenzhou Medical College, Wenzhou 325000, Zhejiang Province, China,
Corresponding author: Weijian Chen, Chief physician, Department of Radiology, First Affiliated Hospital of Wenzhou Medical College, Wenzhou 325000, Zhejiang Province, China (N20080812001/YJ)
| | - Yuxia Duan
- Department of Radiology, First Affiliated Hospital of Wenzhou Medical College, Wenzhou 325000, Zhejiang Province, China
| | - Hongqing Wang
- Department of Radiology, First Affiliated Hospital of Wenzhou Medical College, Wenzhou 325000, Zhejiang Province, China
| | - Xiaotong Wang
- Second Affiliated Hospital of Wenzhou Medical College, Wenzhou 325000, Zhejiang Province, China
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