1
|
Golay X, Ho ML. Multidelay ASL of the pediatric brain. Br J Radiol 2022; 95:20220034. [PMID: 35451851 PMCID: PMC10996417 DOI: 10.1259/bjr.20220034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Accepted: 03/22/2022] [Indexed: 11/05/2022] Open
Abstract
Arterial spin labeling (ASL) is a powerful noncontrast MRI technique for evaluation of cerebral blood flow (CBF). A key parameter in single-delay ASL is the choice of postlabel delay (PLD), which refers to the timing between the labeling of arterial free water and measurement of flow into the brain. Multidelay ASL (MDASL) utilizes several PLDs to improve the accuracy of CBF calculations using arterial transit time (ATT) correction. This approach is particularly helpful in situations where ATT is unknown, including young subjects and slow-flow conditions. In this article, we discuss the technical considerations for MDASL, including labeling techniques, quantitative metrics, and technical artefacts. We then provide a practical summary of key clinical applications with real-life imaging examples in the pediatric brain, including stroke, vasculopathy, hypoxic-ischemic injury, epilepsy, migraine, tumor, infection, and metabolic disease.
Collapse
Affiliation(s)
- Xavier Golay
- MR Neurophysics and Translational Neuroscience, UCL Queen
Square Institute of Neurology London, London,
England, UK
| | - Mai-Lan Ho
- Radiology, Nationwide Children’s Hospital and The Ohio
State University, Columbus, OH,
USA
| |
Collapse
|
2
|
Jin Y, Bai X, Jiang B, Guo Z, Mu Q. Repetitive Transcranial Magnetic Stimulation Induces Quantified Functional and Structural Changes in Subcortical Stroke: A Combined Arterial Spin Labeling Perfusion and Diffusion Tensor Imaging Study. Front Hum Neurosci 2022; 16:829688. [PMID: 35463928 PMCID: PMC9019060 DOI: 10.3389/fnhum.2022.829688] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Accepted: 02/28/2022] [Indexed: 11/26/2022] Open
Abstract
Purpose To explore the changes of cerebral blood flow (CBF) and fractional anisotropy (FA) in stroke patients with motor dysfunction after repetitive transcranial magnetic stimulation (rTMS) treatment, and to better understand the role of rTMS on motor rehabilitation of subcortical stroke patients from the perfusion and structural level. Materials and Methods In total, 23 first-episode acute ischemic stroke patients and sixteen healthy controls (HCs) were included. The patients were divided into the rTMS and sham group. The rehabilitation assessments and examination of perfusion and structural MRI were performed before and after rTMS therapy for each patient. Voxel-based analysis was used to detect the difference in CBF and FA among all three groups. The Pearson correlation analysis was conducted to evaluate the relationship between the CBF/FA value and the motor scales. Results After rTMS, significantly increased CBF was found in the ipsilesional supplementary motor area, postcentral gyrus, precentral gyrus, pons, medulla oblongata, contralesional midbrain, superior cerebellar peduncle, and middle cerebellar peduncle compared to that during the prestimulation and in the sham group, these fasciculi comprise the cortex-pontine-cerebellum-cortex (CPC) loop. Besides, altered CBF in the ipsilesional precentral gyrus, postcentral gyrus, and pons was positively associated with the improved Fugl-Meyer assessment (FMA) scores. Significantly decreased FA was found in the contralesional precentral gyrus, increased FA was found in the ipsilesional postcentral gyrus, precentral gyrus, contralesional supplementary motor area, and bilateral cerebellum, these fasciculi comprise the corticospinal tract (CST). The change of FMA score was positively correlated with altered FA value in the ipsilesional postcentral gyrus and negatively correlated with altered FA value in the contralesional precentral gyrus. Conclusion Our results suggested that rTMS could facilitate the motor recovery of stroke patients. High frequency could promote the improvement of functional activity of ipsilesional CPC loop and the recovery of the microstructure of CST.
Collapse
Affiliation(s)
- Yu Jin
- Department of Radiology, Chengdu Second People’s Hospital, Chengdu, China
| | - Xi Bai
- Department of Radiology, Langzhong People’s Hospital, Langzhong, China
| | - Binghu Jiang
- Department of Radiology, Nanchong Central Hospital, Institute of Rehabilitation and Imaging of Brain Function, The Second Clinical Medical College of North Sichuan Medical College, Nanchong, China
| | - Zhiwei Guo
- Department of Radiology, Nanchong Central Hospital, Institute of Rehabilitation and Imaging of Brain Function, The Second Clinical Medical College of North Sichuan Medical College, Nanchong, China
- *Correspondence: Zhiwei Guo,
| | - Qiwen Mu
- Department of Radiology, Nanchong Central Hospital, Institute of Rehabilitation and Imaging of Brain Function, The Second Clinical Medical College of North Sichuan Medical College, Nanchong, China
- Qiwen Mu,
| |
Collapse
|
3
|
Wang DJJ, Le Bihan D, Krishnamurthy R, Smith M, Ho ML. Noncontrast Pediatric Brain Perfusion: Arterial Spin Labeling and Intravoxel Incoherent Motion. Magn Reson Imaging Clin N Am 2021; 29:493-513. [PMID: 34717841 DOI: 10.1016/j.mric.2021.06.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Noncontrast magnetic resonance imaging techniques for measuring brain perfusion include arterial spin labeling (ASL) and intravoxel incoherent motion (IVIM). These techniques provide noninvasive and repeatable assessment of cerebral blood flow or cerebral blood volume without the need for intravenous contrast. This article discusses the technical aspects of ASL and IVIM with a focus on normal physiologic variations, technical parameters, and artifacts. Multiple pediatric clinical applications are presented, including tumors, stroke, vasculopathy, vascular malformations, epilepsy, migraine, trauma, and inflammation.
Collapse
Affiliation(s)
- Danny J J Wang
- USC Institute for Neuroimaging and Informatics, SHN, 2025 Zonal Avenue, Health Sciences Campus, Los Angeles, CA 90033, USA
| | - Denis Le Bihan
- NeuroSpin, Centre d'études de Saclay, Bâtiment 145, Gif-sur-Yvette 91191, France
| | - Ram Krishnamurthy
- Department of Radiology, Nationwide Children's Hospital, 700 Children's Drive - ED4, Columbus, OH 43205, USA
| | - Mark Smith
- Department of Radiology, Nationwide Children's Hospital, 700 Children's Drive - ED4, Columbus, OH 43205, USA
| | - Mai-Lan Ho
- Department of Radiology, Nationwide Children's Hospital, 700 Children's Drive - ED4, Columbus, OH 43205, USA.
| |
Collapse
|
4
|
Bambach S, Smith M, Morris PP, Campeau NG, Ho ML. Arterial Spin Labeling Applications in Pediatric and Adult Neurologic Disorders. J Magn Reson Imaging 2020; 55:698-719. [PMID: 33314349 DOI: 10.1002/jmri.27438] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Revised: 10/26/2020] [Accepted: 10/27/2020] [Indexed: 12/17/2022] Open
Abstract
Arterial spin labeling (ASL) is a powerful noncontrast magnetic resonance imaging (MRI) technique that enables quantitative evaluation of brain perfusion. To optimize the clinical and research utilization of ASL, radiologists and physicists must understand the technical considerations and age-related variations in normal and disease states. We discuss advanced applications of ASL across the lifespan, with example cases from children and adults covering a wide variety of pathologies. Through literature review and illustrated clinical cases, we highlight the subtleties as well as pitfalls of ASL interpretation. First, we review basic physical principles, techniques, and artifacts. This is followed by a discussion of normal perfusion variants based on age and physiology. The three major categories of perfusion abnormalities-hypoperfusion, hyperperfusion, and mixed patterns-are covered with an emphasis on clinical interpretation and relationship to the disease process. Major etiologies of hypoperfusion include large artery, small artery, and venous disease; other vascular conditions; global hypoxic-ischemic injury; and neurodegeneration. Hyperperfusion is characteristic of vascular malformations and tumors. Mixed perfusion patterns can be seen with epilepsy, migraine, trauma, infection/inflammation, and toxic-metabolic encephalopathy. LEVEL OF EVIDENCE: 4 TECHNICAL EFFICACY STAGE: 3.
Collapse
Affiliation(s)
- Sven Bambach
- Abigail Wexner Research Institute, Nationwide Children's Hospital, Columbus, Ohio, USA
| | - Mark Smith
- Department of Radiology, Nationwide Children's Hospital, Columbus, Ohio, USA
| | - P Pearse Morris
- Department of Radiology, Mayo Clinic, Rochester, Minnesota, USA
| | | | - Mai-Lan Ho
- Department of Radiology, Nationwide Children's Hospital, Columbus, Ohio, USA
| |
Collapse
|
5
|
Cannella R, Sparacia G, Lo Re V, Oddo E, Mamone G, Miraglia R. Advanced magnetic resonance imaging of cortical laminar necrosis in patients with stroke. Neuroradiol J 2019; 32:431-437. [PMID: 31566507 DOI: 10.1177/1971400919876621] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
PURPOSE The aim of this study was to assess the novel advanced magnetic resonance imaging findings of acute stage cortical laminar necrosis developing after complicated cardiovascular or abdominal surgery. MATERIALS AND METHODS This institutional review board-approved study included patients with postoperative stroke due to cortical laminar necrosis imaged with magnetic resonance in the acute stage. Brain magnetic resonance imaging examinations were obtained on a 3T magnetic resonance scanner within 48 hours of the neurological symptoms, including diffusion-weighted images (b value, 1000 s/mm2) and arterial spin labelling using a pseudo-continuous arterial spin labelling method in four patients. Conventional and advanced magnetic resonance images were analysed to assess the imaging features in acute stage cortical laminar necrosis. RESULTS The final population consisted of 14 patients (seven men and seven women, mean age 61 years, range 32-79 years) diagnosed with stroke and acute phase cortical laminar necrosis. All the patients presented with cortical lesions showing restricted diffusion on diffusion-weighted images and hypointensity on the apparent diffusion coefficient map. Cortical hyperintensity on T2-weighted or fluid-attenuated inversion recovery images was found in three (21%) and six (43%) patients, respectively. Reduced perfusion was noted in three out of four patients imaged with arterial spin labelling, while in one case no corresponding perfusion abnormality was noted on the arterial spin labelling maps. Arterial spin labelling abnormalities were much more extensive than diffusion restriction in two patients, and they were associated with a poor outcome. CONCLUSION Cortical hyperintense abnormalities on diffusion-weighted imaging may be the only sign of developing cortical laminar necrosis injury. The acquisition of arterial spin labelling helps to identify perfusion alterations and the extension of the ischaemic injury.
Collapse
Affiliation(s)
- Roberto Cannella
- Radiology Service, Biomedicina, Neuroscienze e Diagnostica avanzata (BIND) Department, University of Palermo, Italy
| | - Gianvincenzo Sparacia
- Radiology Service, Biomedicina, Neuroscienze e Diagnostica avanzata (BIND) Department, University of Palermo, Italy.,Radiology Service, Department of Diagnostic and Therapeutic Services, Mediterranean Institute for Transplantation and Advanced Specialized Therapies (IRCCS-ISMETT), Italy
| | - Vincenzina Lo Re
- Neurology Service, Department of Diagnostic and Therapeutic Services, Mediterranean Institute for Transplantation and Advanced Specialized Therapies (IRCCS-ISMETT), Via Ernesto Tricomi 5, 90127, Palermo, Italy
| | - Elisa Oddo
- Radiology Service, Biomedicina, Neuroscienze e Diagnostica avanzata (BIND) Department, University of Palermo, Italy
| | - Giuseppe Mamone
- Radiology Service, Department of Diagnostic and Therapeutic Services, Mediterranean Institute for Transplantation and Advanced Specialized Therapies (IRCCS-ISMETT), Italy
| | - Roberto Miraglia
- Radiology Service, Department of Diagnostic and Therapeutic Services, Mediterranean Institute for Transplantation and Advanced Specialized Therapies (IRCCS-ISMETT), Italy
| |
Collapse
|
6
|
Chen CY, Li CW, Mak HKF, Lin MF, Chan WP. Combined native magnetic resonance angiography, flow-quantifying, and perfusion-imaging for impending second-stroke assessment. Quant Imaging Med Surg 2019; 9:521-529. [PMID: 31032198 DOI: 10.21037/qims.2019.03.10] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
This special report introduces native flow quantitative imaging for evaluating stroke risk. Moreover, the advantage of combining three imaging techniques [magnetic resonance angiography (MRA), phase-contrast (PC) flow imaging, and arterial spin-labeling imaging] is shown to be beneficial for responding to ischemia and preserving viable neurons. These quantitative imaging techniques provide authoritative information for diagnosing impending stroke and selecting appropriate treatment.
Collapse
Affiliation(s)
- Chia-Yuen Chen
- Department of Radiology, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan.,Department of Radiology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Chia-Wei Li
- Department of Radiology, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
| | - Henry Ka Fung Mak
- Department of Diagnostic Radiology, The University of Hong Kong, Hong Kong SAR, China
| | - Ming-Fang Lin
- Department of Radiology, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan.,Department of Medical Imaging and Radiological Technology, Yuanpei University, Hsinchu, Taiwan
| | - Wing P Chan
- Department of Radiology, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan.,Department of Radiology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| |
Collapse
|
7
|
Zhou F, Huang M, Gu L, Hong S, Jiang J, Zeng X, Gong H. Regional cerebral hypoperfusion after acute sleep deprivation: A STROBE-compliant study of arterial spin labeling fMRI. Medicine (Baltimore) 2019; 98:e14008. [PMID: 30633191 PMCID: PMC6336630 DOI: 10.1097/md.0000000000014008] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Previous neuroimaging studies have shown that functional changes occur after acute sleep deprivation, which suggest detrimental effects of a lack of sleep on the intrinsic functional architecture of the brain. We aimed to identify regional resting perfusion changes in subjects with acute sleep deprivation.Thirty-three healthy subjects with habitual good sleep participated in 36 hours (2 days and 1 night) of sleep deprivation and then underwent the attention network test and pseudo-continuous arterial spin labeling scanning. Regional cerebral blood flow was used to compare cerebral perfusion before and after sleep deprivation. Correlation analyses of regional perfusion changes and scores on the attention network test were performed.Compared with the baseline (n = 20) scans, the scans of subjects after sleep deprivation (n = 26) revealed a slower response time (549.99 milliseconds vs 603.36 milliseconds; t = -2.301; P = .028) and a significantly higher lapse rate (0.88% vs 22.85%; t = -2.977; P = .006). The sleep deprivation subjects showed lower cerebral blood flow (CBF) in the left parahippocampal gyrus/fusiform cortex (pHipp/Fus), right pHipp/Fus, and right prefrontal cortex (PFC) relative to the baseline subjects (Gaussian random field correction, voxel level P < .01, and cluster level P < .05). Although no significant relationships were observed between the altered regional CBF (rCBF) values and the attention network test scores, the receiver-operating characteristic and leave-one-out cross-validation analyses revealed that significant decreases in rCBF in the bilateral pHipp/Fus and right PFC could discriminate between sleep deprivation and good sleep status.We observed that rCBF was reduced after 36 hours (2 days and 1 night) of sleep deprivation. Our preliminary findings suggest an acute vulnerability to hypoperfusion due to lack of sleep.
Collapse
Affiliation(s)
- Fuqing Zhou
- Department of Radiology, The First Affiliated Hospital
- Neuroradiology Lab, Jiangxi Province Medical Imaging Research Institute
| | - Muhua Huang
- Department of Radiology, The First Affiliated Hospital
- Neuroradiology Lab, Jiangxi Province Medical Imaging Research Institute
| | - Lili Gu
- Department of Clinical Pain, The First Affiliated Hospital, Nanchang University, Nanchang, Jiangxi Province, China
| | - Shunda Hong
- Department of Radiology, The First Affiliated Hospital
- Neuroradiology Lab, Jiangxi Province Medical Imaging Research Institute
| | - Jian Jiang
- Department of Radiology, The First Affiliated Hospital
- Neuroradiology Lab, Jiangxi Province Medical Imaging Research Institute
| | - Xianjun Zeng
- Department of Radiology, The First Affiliated Hospital
- Neuroradiology Lab, Jiangxi Province Medical Imaging Research Institute
| | - Honghan Gong
- Department of Radiology, The First Affiliated Hospital
- Neuroradiology Lab, Jiangxi Province Medical Imaging Research Institute
| |
Collapse
|
8
|
Abstract
Electroconvulsive therapy (ECT) is a safe and effective treatment for major depressive disorder, but cerebrovascular and cardiovascular complications, although rare, remain the most concerning. This is particularly notable in those with preexisting cerebrovascular disease, which impacts dynamic cerebral autoregulation. In these patients, the increased blood flow to the seizing portions of the brain induced by ECT potentially can reduce cerebral blood flow to ischemic areas, possibly causing adverse neurological events. The authors describe a patient with chronic cerebral ischemic disease, chronic anemia, and major depressive disorder undergoing ECT to achieve remission. The patient developed recurrent focal neurological deficits after each ECT procedure, with neurological recovery within 48 hours post-ECT. Clinical guidelines may need to be updated for the management of ECT patients with cerebrovascular disease who may be at an increased risk of intraictal and possibly postictal regional ischemia, especially in areas already compromised by a prior stroke and/or by reduced cerebral oxygenation caused by symptomatic anemia at risk of ischemia. Research is needed to assess changes in regional cerebral blood flow during and after ECT in patients with cerebrovascular disease, including small-vessel cerebral ischemia, and to evaluate these changes in relation to the location, intensity, and duration of induced seizure.
Collapse
|
9
|
Zhou F, Huang M, Wu L, Tan Y, Guo J, Zhang Y, He L, Gong H. Altered perfusion of the sensorimotor cortex in patients with cervical spondylotic myelopathy: an arterial spin labeling study. J Pain Res 2018; 11:181-190. [PMID: 29391824 PMCID: PMC5769569 DOI: 10.2147/jpr.s148076] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
Objective Advanced magnetic resonance imaging studies have shown functional plasticity or reorganization and metabolite alterations of N-acetyl aspartate in the sensorimotor cortex (SMC), a hallmark region and key brain network, in patients with cervical spondylotic myelopathy (CSM). However, the nature of perfusion in the SMC and the relationship between regional cerebral blood flow (CBF), motor function scores, and structural damage of the cervical cord in patients with CSM are not fully understood. Materials and methods All right-handed participants underwent pseudo-continuous arterial spin labeling pulse sequence scanning, and CBF was then calculated and compared between CSM and healthy groups. Clinical and structural associations were assessed in the SMC. Receiver operating characteristic (ROC) and leave-one-out cross-validation analyses were used to estimate the sensitivity and specificity of the significantly altered CBF in the SMC to distinguish myelopathy-related impairment. Results A total of 18 pairs of CSM patients and well-matched healthy subjects were included in the analyses. Compared with healthy subjects, CSM patients exhibited significantly decreased CBF in the left premotor ventral/precentral operculum (PMv/PrCO) and the bilateral dorsal anterior cingulate cortex (dACC); and increased CBF in the left paracentral lobule (PCL), the right PCL/supplementary motor area (PCL/SMA), and the right postcentral gyrus (PoCG; Gaussian random field correction at P<0.01). In the CSM group, the CBF values in the right PoCG were negatively correlated with Japanese Orthopaedic Association scores, and the CBF values in several regions were negatively correlated with Neck Disability Index scores. Finally, the ROC analysis revealed that significantly increased CBF in the left PCL, the right PCL/SMA, and the right PoCG discriminated patients with myelopathy-related impairment from healthy subjects. Conclusion Regional CBF was reduced in operculum-integrated (PMv/PrCO) and motor control (dACC) regions but increased in sensory (PoCG) and motor-sensory processing (PCL/SMA) regions in patients with CSM.
Collapse
Affiliation(s)
- Fuqing Zhou
- Department of Radiology, the First Affiliated Hospital, Nanchang University, Nanchang, Jiangxi Province, People's Republic of China.,Jiangxi Province Medical Imaging Research Institute, Nanchang, Jiangxi Province, People's Republic of China
| | - Muhua Huang
- Department of Radiology, the First Affiliated Hospital, Nanchang University, Nanchang, Jiangxi Province, People's Republic of China.,Jiangxi Province Medical Imaging Research Institute, Nanchang, Jiangxi Province, People's Republic of China
| | - Lin Wu
- Department of Radiology, the First Affiliated Hospital, Nanchang University, Nanchang, Jiangxi Province, People's Republic of China.,Jiangxi Province Medical Imaging Research Institute, Nanchang, Jiangxi Province, People's Republic of China
| | - Yongming Tan
- Department of Radiology, the First Affiliated Hospital, Nanchang University, Nanchang, Jiangxi Province, People's Republic of China.,Jiangxi Province Medical Imaging Research Institute, Nanchang, Jiangxi Province, People's Republic of China
| | - Jianqiang Guo
- Department of Radiology, the First Affiliated Hospital, Nanchang University, Nanchang, Jiangxi Province, People's Republic of China.,Jiangxi Province Medical Imaging Research Institute, Nanchang, Jiangxi Province, People's Republic of China
| | - Yong Zhang
- Department of Pain Clinic, the First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi Province, People's Republic of China
| | - Laichang He
- Department of Radiology, the First Affiliated Hospital, Nanchang University, Nanchang, Jiangxi Province, People's Republic of China.,Jiangxi Province Medical Imaging Research Institute, Nanchang, Jiangxi Province, People's Republic of China
| | - Honghan Gong
- Department of Radiology, the First Affiliated Hospital, Nanchang University, Nanchang, Jiangxi Province, People's Republic of China.,Jiangxi Province Medical Imaging Research Institute, Nanchang, Jiangxi Province, People's Republic of China
| |
Collapse
|
10
|
Robertson AD, Marzolini S, Middleton LE, Basile VS, Oh PI, MacIntosh BJ. Exercise Training Increases Parietal Lobe Cerebral Blood Flow in Chronic Stroke: An Observational Study. Front Aging Neurosci 2017; 9:318. [PMID: 29033829 PMCID: PMC5626868 DOI: 10.3389/fnagi.2017.00318] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2017] [Accepted: 09/15/2017] [Indexed: 02/01/2023] Open
Abstract
Exercise is increasingly recommended as an essential component of stroke rehabilitation, yet uncertainty remains with respect to its direct effect on the cerebral vasculature. The current study first demonstrated the repeatability of pseudo-continuous arterial spin labeling (ASL) magnetic resonance imaging (MRI) in older adults with stroke, and then investigated the change in cerebrovascular function following a 6-month cardiovascular rehabilitation program. In the repeatability study, 12 participants at least 3 months post-stroke underwent two ASL imaging scans 1 month apart. In the prospective observational study, eight individuals underwent ASL imaging and aerobic fitness testing before and after a 6-month cardiovascular rehabilitation program. Cerebral blood flow (CBF) and the spatial coefficient of variation of CBF (sCoV) were quantified to characterize tissue-level perfusion and large cerebral artery transit time properties, respectively. In repeat scanning, intraclass correlation (ICC) indicated moderate test-retest reliability for global gray matter CBF (ICC = 0.73) and excellent reliability for sCoV (ICC = 0.94). In the observational study, gray matter CBF increased after training (baseline: 40 ± 13 vs. 6-month: 46 ± 12 ml·100 g−1·min−1, P = 0.036). The greatest change occurred in the parietal lobe (+18 ± 12%). Gray matter sCoV, however, did not change following training (P = 0.31). This study provides preliminary evidence that exercise-based rehabilitation in chronic stroke enhances tissue-level perfusion, without changing the relative hemodynamic properties of the large cerebral arteries.
Collapse
Affiliation(s)
- Andrew D Robertson
- Heart and Stroke Foundation Canadian Partnership for Stroke Recovery, Ottawa, ON, Canada.,Hurvitz Brain Sciences, Sunnybrook Research Institute, University of Toronto, Toronto, ON, Canada
| | - Susan Marzolini
- Heart and Stroke Foundation Canadian Partnership for Stroke Recovery, Ottawa, ON, Canada.,Toronto Rehab, University Health Network, Toronto, ON, Canada
| | - Laura E Middleton
- Heart and Stroke Foundation Canadian Partnership for Stroke Recovery, Ottawa, ON, Canada.,Department of Kinesiology, University of Waterloo, Waterloo, ON, Canada
| | | | - Paul I Oh
- Heart and Stroke Foundation Canadian Partnership for Stroke Recovery, Ottawa, ON, Canada.,Toronto Rehab, University Health Network, Toronto, ON, Canada.,Peter Munk Cardiac Centre, University of Toronto, Toronto, ON, Canada
| | - Bradley J MacIntosh
- Heart and Stroke Foundation Canadian Partnership for Stroke Recovery, Ottawa, ON, Canada.,Hurvitz Brain Sciences, Sunnybrook Research Institute, University of Toronto, Toronto, ON, Canada
| |
Collapse
|
11
|
Robertson AD, Matta G, Basile VS, Black SE, Macgowan CK, Detre JA, MacIntosh BJ. Temporal and Spatial Variances in Arterial Spin-Labeling Are Inversely Related to Large-Artery Blood Velocity. AJNR Am J Neuroradiol 2017; 38:1555-1561. [PMID: 28619834 DOI: 10.3174/ajnr.a5257] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2016] [Accepted: 04/10/2017] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE The relationship between extracranial large-artery characteristics and arterial spin-labeling MR imaging may influence the quality of arterial spin-labeling-CBF images for older adults with and without vascular pathology. We hypothesized that extracranial arterial blood velocity can explain between-person differences in arterial spin-labeling data systematically across clinical populations. MATERIALS AND METHODS We performed consecutive pseudocontinuous arterial spin-labeling and phase-contrast MR imaging on 82 individuals (20-88 years of age, 50% women), including healthy young adults, healthy older adults, and older adults with cerebral small vessel disease or chronic stroke infarcts. We examined associations between extracranial phase-contrast hemodynamics and intracranial arterial spin-labeling characteristics, which were defined by labeling efficiency, temporal signal-to-noise ratio, and spatial coefficient of variation. RESULTS Large-artery blood velocity was inversely associated with labeling efficiency (P = .007), temporal SNR (P < .001), and spatial coefficient of variation (P = .05) of arterial spin-labeling, after accounting for age, sex, and group. Correction for labeling efficiency on an individual basis led to additional group differences in GM-CBF compared to correction using a constant labeling efficiency. CONCLUSIONS Between-subject arterial spin-labeling variance was partially explained by extracranial velocity but not cross-sectional area. Choosing arterial spin-labeling timing parameters with on-line knowledge of blood velocity may improve CBF quantification.
Collapse
Affiliation(s)
- A D Robertson
- From the Heart and Stroke Foundation Canadian Partnership for Stroke Recovery (A.D.R., G.M., S.E.B., B.J.M.) .,Hurvitz Brain Sciences (A.D.R., S.E.B., B.J.M.), Sunnybrook Research Institute, University of Toronto, Toronto, Ontario, Canada
| | - G Matta
- From the Heart and Stroke Foundation Canadian Partnership for Stroke Recovery (A.D.R., G.M., S.E.B., B.J.M.)
| | - V S Basile
- Division of Neurology, Department of Medicine (V.S.B., S.E.B.), University of Toronto, Toronto, Ontario, Canada.,Mackenzie Health (V.S.B.), Richmond Hill, Ontario, Canada
| | - S E Black
- From the Heart and Stroke Foundation Canadian Partnership for Stroke Recovery (A.D.R., G.M., S.E.B., B.J.M.).,Hurvitz Brain Sciences (A.D.R., S.E.B., B.J.M.), Sunnybrook Research Institute, University of Toronto, Toronto, Ontario, Canada.,Division of Neurology, Department of Medicine (V.S.B., S.E.B.), University of Toronto, Toronto, Ontario, Canada.,L.C. Campbell Cognitive Neurology Research Unit (S.E.B.), Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
| | - C K Macgowan
- Hospital for Sick Children (C.K.M.), Toronto, Ontario, Canada.,Department of Medical Biophysics (C.K.M., B.J.M.), University of Toronto, Toronto, Ontario, Canada
| | - J A Detre
- Department of Neurology (J.A.D.), University of Pennsylvania, Philadelphia, Pennsylvania
| | - B J MacIntosh
- From the Heart and Stroke Foundation Canadian Partnership for Stroke Recovery (A.D.R., G.M., S.E.B., B.J.M.).,Hurvitz Brain Sciences (A.D.R., S.E.B., B.J.M.), Sunnybrook Research Institute, University of Toronto, Toronto, Ontario, Canada.,Department of Medical Biophysics (C.K.M., B.J.M.), University of Toronto, Toronto, Ontario, Canada
| |
Collapse
|
12
|
Li R, Xiao HF, Lyu JH, J.J. Wang D, Ma L, Lou X. Differential diagnosis of mitochondrial encephalopathy with lactic acidosis and stroke-like episodes (MELAS) and ischemic stroke using 3D pseudocontinuous arterial spin labeling. J Magn Reson Imaging 2016; 45:199-206. [PMID: 27348222 DOI: 10.1002/jmri.25354] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2016] [Accepted: 06/09/2016] [Indexed: 01/16/2023] Open
Affiliation(s)
- Rui Li
- Department of Radiology; Chinese PLA General Hospital; Beijing China
- School of Medicine; Nankai University; Tianjin China
| | - Hua-feng Xiao
- Department of Radiology; Chinese PLA General Hospital; Beijing China
- Department of Radiology; Chinese PLA 302 Hospital; Beijing China
| | - Jin-hao Lyu
- Department of Radiology; Chinese PLA General Hospital; Beijing China
| | - Danny J.J. Wang
- Department of Neurology; University of California; Los Angeles California USA
| | - Lin Ma
- Department of Radiology; Chinese PLA General Hospital; Beijing China
| | - Xin Lou
- Department of Radiology; Chinese PLA General Hospital; Beijing China
- Department of Neurology; University of California; Los Angeles California USA
| |
Collapse
|
13
|
Li Z, Li N, Qu Y, Gai F, Zhang G, Zhang G. Application of 3.0T magnetic resonance arterial spin labeling (ASL) technology in mild and moderate intracranial atherosclerotic stenosis. Exp Ther Med 2016; 12:297-301. [PMID: 27347052 PMCID: PMC4907036 DOI: 10.3892/etm.2016.3318] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2015] [Accepted: 05/06/2016] [Indexed: 11/05/2022] Open
Abstract
The application value of 3.0T magnetic resonance arterial spin labeling (ASL) technology in mild and moderate intracranial atherosclerotic stenosis was evaluated. A total of 58 cases of transient ischemic attack (TIA) and 60 cases of ischemic cerebral apoplexy cases were selected. The cases were analysed using a GE Healthcare Signa HDx 3.0T superconducting whole-body magnetic resonance scan within 24 h of attack. Eight-channel head phased array coils and conventional sequence were used to create T1-weighted images (T1WI), T2WI, diffusion-weighted imaging, magnetic resonance angiography (MRA) and ASL imaging, which were generated into ASL pseudo-color images (blue was hypoperfusion area) through post-processing in order to compare and analyze the correlation and differences between ASL and conventional imaging in terms of lesion location, size, blood perfusion situation and signal range of relative cerebral blood flow (rCBF). The results showed that, 13 TIA cases of abnormal signal in conventional magnetic resonance imaging (MRI) can also be found through ASL technology. Diameter stenosis beyond 30% in MRA can also be tested in ASL. A positive rate in ASL was significantly higher than that of conventional MRI (χ2=29.078, P<0.001) and hypoperfusion area was greatly increased (t=32.526, P<0.001). The rCBF value was positively correlated with the degree of diameter stenosis shown in MRA (r=0.524, P=0.012). Additionally, the positive rate of ASL was positively correlated with the attack times of TIA (r=0.352, P=0.027). A total of 39 cerebral apoplexy cases of abnormal signal in conventional MRI were also found through ASL technology. A positive rate in ASL was significantly higher than that of conventional MRI (χ2=7.685, P=0.006) and hypoperfusion area was greatly increased (t=9.425, P<0.001). The rCBF value was positively correlated with the degree of diameter stenosis (r=0.635, P=0.009). In conclusion, 3.0T ASL correlated with early diagnosis of TIA and mild and moderate intracranial arterial stenosis of cerebral apoplexy.
Collapse
Affiliation(s)
- Zhongwei Li
- CT Room, Yantaishan Hospital, Yantai, Shandong 264001, P.R. China
| | - Naikun Li
- Department of Medical Imaging, Yantai Affiliated Hospital of Binzhou Medical University, Yantai, Shandong 264100, P.R. China
| | - Yanyan Qu
- Department of Endocrinology, Yantaishan Hospital, Yantai, Shandong 264001, P.R. China
| | - Feng Gai
- Department of Radiology, Yantai Municipal Laiyang Central Hospital, Yantai, Shandong 265200, P.R. China
| | - Guowei Zhang
- CT Room, Yantaishan Hospital, Yantai, Shandong 264001, P.R. China
| | - Guanghui Zhang
- Department of Medical Imaging, Yantai Affiliated Hospital of Binzhou Medical University, Yantai, Shandong 264100, P.R. China
| |
Collapse
|