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Bapuraj JR, Chaudhary N, Masood K, Srinivasan A. The Current Role of SWI in Imaging Cerebrovascular Disorders: Susceptible to Further Advances? Semin Roentgenol 2024; 59:165-171. [PMID: 38880515 DOI: 10.1053/j.ro.2024.01.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2024] [Accepted: 01/31/2024] [Indexed: 06/18/2024]
Affiliation(s)
- Jayapalli Rajiv Bapuraj
- Department of Radiology, Division of Neuroradiology, University of Michigan, University Hospital, Ann Arbor, MI.
| | - Neeraj Chaudhary
- Department of Radiology, Division of Neuroradiology, University of Michigan, University Hospital, Ann Arbor, MI
| | - Kamran Masood
- Department of Radiology, University of Minnesota, Minneapolis, MN
| | - Ashok Srinivasan
- Department of Radiology, Division of Neuroradiology, University of Michigan, University Hospital, Ann Arbor, MI
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Gullapalli P, Fossati N, Stamenkovic D, Haque M, Cattano D. Tale of Two Cities: narrative review of oxygen. F1000Res 2023; 12:246. [PMID: 37224313 PMCID: PMC10189297 DOI: 10.12688/f1000research.130592.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/05/2023] [Indexed: 05/26/2023] Open
Abstract
The human brain contributes 2% of the body weight yet receives 15% of cardiac output and demands a constant supply of oxygen (O 2) and nutrients to meet its metabolic needs. Cerebral autoregulation is responsible for maintaining a constant cerebral blood flow that provides the supply of oxygen and maintains the energy storage capacity. We selected oxygen administration-related studies published between 1975-2021 that included meta-analysis, original research, commentaries, editorial, and review articles. In the present narrative review, several important aspects of the oxygen effects on brain tissues and cerebral autoregulation are discussed, as well the role of exogenous O 2 administration in patients with chronic ischemic cerebrovascular disease: We aimed to revisit the utility of O 2 administration in pathophysiological situations whether or not being advantageous. Indeed, a compelling clinical and experimental body of evidence questions the utility of routine oxygen administration in acute and post-recovery brain ischemia, as evident by studies in neurophysiology imaging. While O 2 is still part of common clinical practice, it remains unclear whether its routine use is safe.
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Affiliation(s)
- Pranathi Gullapalli
- Department of Anesthesiology, McGovern Medical School UTHealth, Hosuton, USA
| | - Nicoletta Fossati
- Department of Anaesthesia, St George’s Hospital and Medical School, London, UK
| | | | - Muhammad Haque
- Department of Neurology, McGovern Medical School UTHealth, Houston, USA
| | - Davide Cattano
- Department of Anesthesiology, McGovern Medical School UTHealth, Hosuton, USA
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Meng Y, Li CX, Zhang X. Quantitative Evaluation of Oxygen Extraction Fraction Changes in the Monkey Brain during Acute Stroke by Using Quantitative Susceptibility Mapping. Life (Basel) 2023; 13:1008. [PMID: 37109537 PMCID: PMC10146121 DOI: 10.3390/life13041008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Revised: 04/05/2023] [Accepted: 04/10/2023] [Indexed: 04/29/2023] Open
Abstract
BACKGROUND The oxygen extraction fraction (OEF) indicates the brain's oxygen consumption and can be estimated by using the quantitative susceptibility mapping (QSM) MRI technique. Recent studies have suggested that OEF alteration following stroke is associated with the viability of at-risk tissue. In the present study, the temporal evolution of OEF in the monkey brain during acute stroke was investigated using QSM. METHODS Ischemic stroke was induced in adult rhesus monkeys (n = 8) with permanent middle cerebral artery occlusion (pMCAO) by using an interventional approach. Diffusion-, T2-, and T2*-weighted images were conducted on day 0, day 2, and day 4 post-stroke using a clinical 3T scanner. Progressive changes in magnetic susceptibility and OEF, along with their correlations with the transverse relaxation rates and diffusion indices, were examined. RESULTS The magnetic susceptibility and OEF in injured gray matter of the brain significantly increased during the hyperacute phase, and then decreased significantly on day 2 and day 4. Moreover, the temporal changes of OEF in gray matter were moderately correlated with mean diffusivity (MD) (r = 0.52; p = 0.046) from day 0 to day 4. Magnetic susceptibility in white matter progressively increased (from negative values to near zero) during acute stroke, and significant increases were seen on day 2 (p = 0.08) and day 4 (p = 0.003) when white matter was significantly degenerated. However, significant reduction of OEF in white matter was not seen until day 4 post-stroke. CONCLUSION The preliminary results demonstrate that QSM-derived OEF is a robust approach to examine the progressive changes of gray matter in the ischemic brain from the hyperacute phase to the subacute phase of stroke. The changes of OEF in gray matter were more prominent than those in white matter following stroke insult. The findings suggest that QSM-derived OEF may provide complementary information for understanding the neuropathology of the brain tissue following stroke and predicting stroke outcomes.
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Affiliation(s)
- Yuguang Meng
- EPC Imaging Center, Emory National Primate Research Center, Emory University, Atlanta, GA 30329, USA
| | - Chun-Xia Li
- EPC Imaging Center, Emory National Primate Research Center, Emory University, Atlanta, GA 30329, USA
| | - Xiaodong Zhang
- EPC Imaging Center, Emory National Primate Research Center, Emory University, Atlanta, GA 30329, USA
- Division of Neuropharmacology and Neurologic Diseases, Emory National Primate Research Center, Emory University, Atlanta, GA 30329, USA
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Xiang W, Liang Z, Zhang M, Wei H, Sun Z, Lv Y, Meng Y, Li W, Zheng H, Zhang H. Prognostic value of susceptibility-weighted imaging of prominent veins in acute ischemic stroke: A systematic review and meta-analysis. Front Neurol 2022; 13:1052035. [DOI: 10.3389/fneur.2022.1052035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Accepted: 10/25/2022] [Indexed: 12/02/2022] Open
Abstract
BackgroundThe prominent veins sign (PVS) on susceptibility-weighted imaging (SWI) has been suggested to be related to the prognosis of patients with acute ischemic stroke (AIS). This meta-analysis aims to clarify the association between PVS and the prognosis of patients with AIS.MethodsThis meta-analysis was registered in PROSPERO (no. CRD42022343795). We performed systematic research in PubMed, Web of Science, EMBASE, and Cochrane Library databases for studies investigating the prognostic value of PVS. Based on the enrolled studies, patients were divided into two groups as follows: those with PVS cohort and those without PVS cohort. Outcomes were unfavorable functional outcome, early neurological deterioration (END), and hemorrhagic transformation (HT). The random-effects models were used for the meta-analytical pooled. Heterogeneity was estimated using Cochran's Q-test and I2 value. Subgroup and sensitivity analyses were also performed to explore the potential sources of heterogeneity. Publication bias was assessed with funnel plots and using Begger's and Egger's tests.ResultsA total of 19 studies with 1,867 patients were included. PVS was correlated with an unfavorable functional outcome in patients with AIS (risk ratio [RR] 1.61, 95% CI 1.28–2.02), especially in those receiving recanalization therapy (RR 2.00, 95% CI 1.52–2.63), but not in those treated conservatively (RR 1.33, 95% CI 0.87–2.04). Moreover, PVS was related to END (RR 2.77, 95% CI 2.21–3.46), while without an increased risk of HT (RR 0.97, 95% CI 0.64–1.47).ConclusionPVS was associated with an unfavorable prognosis of patients with AIS and increased the risk of END, while not correlated with an increased risk of HT. PVS might be useful for predicting functional outcomes of patients with AIS as a novel imaging maker.Systematic review registrationhttps://www.crd.york.ac.uk/PROSPERO/, identifier: CRD42022343795.
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Murdoch R, Stotesbury H, Hales PW, Kawadler JM, Kölbel M, Clark CA, Kirkham FJ, Shmueli K. A Comparison of MRI Quantitative Susceptibility Mapping and TRUST-Based Measures of Brain Venous Oxygen Saturation in Sickle Cell Anaemia. Front Physiol 2022; 13:913443. [PMID: 36105280 PMCID: PMC9465016 DOI: 10.3389/fphys.2022.913443] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Accepted: 06/15/2022] [Indexed: 11/13/2022] Open
Abstract
In recent years, interest has grown in the potential for magnetic resonance imaging (MRI) measures of venous oxygen saturation (Yv) to improve neurological risk prediction. T2-relaxation-under-spin-tagging (TRUST) is an MRI technique which has revealed changes in Yv in patients with sickle cell anemia (SCA). However, prior studies comparing Yv in patients with SCA relative to healthy controls have reported opposing results depending on whether the calibration model, developed to convert blood T2 to Yv, is based on healthy human hemoglobin (HbA), bovine hemoglobin (HbBV) or sickle hemoglobin (HbS). MRI Quantitative Susceptibility Mapping (QSM) is an alternative technique that may hold promise for estimating Yv in SCA as blood magnetic susceptibility is linearly dependent upon Yv, and no significant difference has been found between the magnetic susceptibility of HbA and HbS. Therefore, the aim of this study was to compare estimates of Yv using QSM and TRUST with five published calibration models in healthy controls and patients with SCA. 17 patients with SCA and 13 healthy controls underwent MRI. Susceptibility maps were calculated from a multi-parametric mapping acquisition and Yv was calculated from the mean susceptibility in a region of interest in the superior sagittal sinus. TRUST estimates of T2, within a similar but much smaller region, were converted to Yv using five different calibration models. Correlation and Bland-Altman analyses were performed to compare estimates of Yv between TRUST and QSM methods. For each method, t-tests were also used to explore group-wise differences between patients with SCA and healthy controls. In healthy controls, significant correlations were observed between QSM and TRUST measures of Yv, while in SCA, there were no such correlations. The magnitude and direction of group-wise differences in Yv varied with method. The TRUST-HbBV and QSM methods suggested decreased Yv in SCA relative to healthy controls, while the TRUST-HbS (p < 0.01) and TRUST-HbA models suggested increased Yv in SCA as in previous studies. Further validation of all MRI measures of Yv, relative to ground truth measures such as O15 PET and jugular vein catheterization, is required in SCA before QSM or TRUST methods can be considered for neurological risk prediction.
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Affiliation(s)
- Russell Murdoch
- Department of Medical Physics and Biomedical Engineering, University College London, London, United Kingdom
| | - Hanne Stotesbury
- Developmental Neurosciences, UCL Great Ormond Street Institute of Child Health, London, United Kingdom
| | - Patrick W. Hales
- Developmental Neurosciences, UCL Great Ormond Street Institute of Child Health, London, United Kingdom
| | - Jamie M. Kawadler
- Developmental Neurosciences, UCL Great Ormond Street Institute of Child Health, London, United Kingdom
| | - Melanie Kölbel
- Developmental Neurosciences, UCL Great Ormond Street Institute of Child Health, London, United Kingdom
| | - Christopher A. Clark
- Developmental Neurosciences, UCL Great Ormond Street Institute of Child Health, London, United Kingdom
| | - Fenella J. Kirkham
- Developmental Neurosciences, UCL Great Ormond Street Institute of Child Health, London, United Kingdom
- Clinical and Experimental Sciences, University of Southampton, Southampton, United Kingdom
| | - Karin Shmueli
- Department of Medical Physics and Biomedical Engineering, University College London, London, United Kingdom
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6
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Jiang D, Lu H. Cerebral oxygen extraction fraction MRI: Techniques and applications. Magn Reson Med 2022; 88:575-600. [PMID: 35510696 PMCID: PMC9233013 DOI: 10.1002/mrm.29272] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Revised: 03/20/2022] [Accepted: 03/29/2022] [Indexed: 12/20/2022]
Abstract
The human brain constitutes 2% of the body's total mass but uses 20% of the oxygen. The rate of the brain's oxygen utilization can be derived from a knowledge of cerebral blood flow and the oxygen extraction fraction (OEF). Therefore, OEF is a key physiological parameter of the brain's function and metabolism. OEF has been suggested to be a useful biomarker in a number of brain diseases. With recent advances in MRI techniques, several MRI-based methods have been developed to measure OEF in the human brain. These MRI OEF techniques are based on the T2 of blood, the blood signal phase, the magnetic susceptibility of blood-containing voxels, the effect of deoxyhemoglobin on signal behavior in extravascular tissue, and the calibration of the BOLD signal using gas inhalation. Compared to 15 O PET, which is considered the "gold standard" for OEF measurement, MRI-based techniques are non-invasive, radiation-free, and are more widely available. This article provides a review of these emerging MRI-based OEF techniques. We first briefly introduce the role of OEF in brain oxygen homeostasis. We then review the methodological aspects of different categories of MRI OEF techniques, including their signal mechanisms, acquisition methods, and data analyses. The strengths and limitations of the techniques are discussed. Finally, we review key applications of these techniques in physiological and pathological conditions.
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Affiliation(s)
- Dengrong Jiang
- The Russell H. Morgan Department of Radiology & Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Hanzhang Lu
- The Russell H. Morgan Department of Radiology & Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.,Department of Biomedical Engineering, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.,F.M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Research Institute, Baltimore, Maryland, USA
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7
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Uchida Y, Kan H, Inoue H, Oomura M, Shibata H, Kano Y, Kuno T, Usami T, Takada K, Yamada K, Kudo K, Matsukawa N. Penumbra Detection With Oxygen Extraction Fraction Using Magnetic Susceptibility in Patients With Acute Ischemic Stroke. Front Neurol 2022; 13:752450. [PMID: 35222239 PMCID: PMC8873150 DOI: 10.3389/fneur.2022.752450] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Accepted: 01/25/2022] [Indexed: 12/14/2022] Open
Abstract
Background The oxygen extraction fraction (OEF) has been applied to identify ischemic penumbral tissue, but is difficult to use in an urgent care setting. This study aimed to investigate whether an OEF map generated via magnetic resonance quantitative susceptibility mapping (QSM) could help identify the ischemic penumbra in patients with acute ischemic stroke. Materials and Methods This prospective imaging study included 21 patients with large anterior circulation vessel occlusion who were admitted <24 h after stroke onset and 21 age-matched healthy controls. We identified the ischemic penumbra as the region with a Tmax of >6 s during dynamic susceptibility contrast-magnetic resonance imaging (DSC-MRI) and calculated the perfusion-core mismatch ratio between the ischemic penumbra and infarct core volumes. The OEF values were measured based on magnetic susceptibility differences between the venous structures and brain tissues using rapid QSM acquisition. Volumes with increased OEF values were compared to the ischemic penumbra volumes using an anatomical template. Results Eleven patients had a perfusion-core mismatch ratio of ≥1.8, and reperfusion therapy was recommended. In these patients, the volumes with increased OEF values of >51.5%, which was defined using the anterior circulation territory OEF values from the 21 healthy controls, were positively correlated with the ischemic penumbra volumes (r = 0.636, 95% CI: 0.059 to 0.895, P = 0.035) and inversely correlated with the 30-day change in the National Institutes of Health Stroke Scale scores (r = −0.624, 95% CI: −0.891 to −0.039, P = 0.041). Conclusion Tissue volumes with increased OEF values could predict ischemic penumbra volumes based on DSC-MRI, highlighting the potential of the QSM-derived OEF map as a penumbra biomarker to guide treatment selection in patients with acute ischemic stroke.
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Affiliation(s)
- Yuto Uchida
- Department of Neurology, Nagoya City University, Nagoya, Japan
- Department of Neurology, Toyokawa City Hospital, Aichi, Japan
| | - Hirohito Kan
- Department of Integrated Health Sciences, Nagoya University, Nagoya, Japan
| | - Hiroyasu Inoue
- Department of Neurology, Nagoya City University, Nagoya, Japan
| | - Masahiro Oomura
- Department of Neurology, Nagoya City University, Nagoya, Japan
| | - Haruto Shibata
- Department of Neurology, Nagoya City East Medical Center, Nagoya, Japan
| | - Yuya Kano
- Department of Neurology, Nagoya City East Medical Center, Nagoya, Japan
| | - Tomoyuki Kuno
- Department of Neurology, Toyokawa City Hospital, Aichi, Japan
| | - Toshihiko Usami
- Department of Neurology, Toyokawa City Hospital, Aichi, Japan
| | - Koji Takada
- Department of Neurology, Toyokawa City Hospital, Aichi, Japan
| | - Kentaro Yamada
- Department of Neurology, Nagoya City East Medical Center, Nagoya, Japan
| | - Kohsuke Kudo
- Department of Diagnostic Imaging, Hokkaido University, Hokkaido, Japan
- Global Center for Biomedical Science and Engineering, Faculty of Medicine, Hokkaido University, Hokkaido, Japan
| | - Noriyuki Matsukawa
- Department of Neurology, Nagoya City University, Nagoya, Japan
- *Correspondence: Noriyuki Matsukawa
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Lundberg A, Lind E, Olsson H, Helms G, Knutsson L, Wirestam R. Comparison of MRI methods for measuring whole‐brain oxygen extraction fraction under different geometric conditions at 7T. J Neuroimaging 2022; 32:442-458. [PMID: 35128747 PMCID: PMC9305937 DOI: 10.1111/jon.12975] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Revised: 12/22/2021] [Accepted: 01/18/2022] [Indexed: 11/28/2022] Open
Abstract
Background and Purpose Methods Results Conclusion
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Affiliation(s)
- Anna Lundberg
- Department of Medical Radiation Physics Lund University Lund Sweden
| | - Emelie Lind
- Department of Medical Radiation Physics Lund University Lund Sweden
| | - Hampus Olsson
- Department of Medical Radiation Physics Lund University Lund Sweden
| | - Gunther Helms
- Department of Medical Radiation Physics Lund University Lund Sweden
| | - Linda Knutsson
- Department of Medical Radiation Physics Lund University Lund Sweden
- Russell H. Morgan Department of Radiology and Radiological Science Johns Hopkins University School of Medicine Baltimore Maryland United States
| | - Ronnie Wirestam
- Department of Medical Radiation Physics Lund University Lund Sweden
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Ebrahimi T, Tafakhori A, Hashemi H, Ali Oghabian M. An interictal measurement of cerebral oxygen extraction fraction in MRI-negative refractory epilepsy using quantitative susceptibility mapping. Phys Med 2021; 85:87-97. [PMID: 33984822 DOI: 10.1016/j.ejmp.2021.03.039] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Revised: 03/19/2021] [Accepted: 03/30/2021] [Indexed: 11/16/2022] Open
Abstract
PURPOSE Oxygen extraction fraction (OEF) can be a factor to identify brain tissue's disability in epileptic patients. This study aimed to assess the OEF's level measurement in refractory epileptic patients (REPs) using a quantitative susceptibility mapping (QSM) method and to determine whether the OEF parameters change. METHODS QSM-OEF maps of 26 REPs and 16 healthy subjects were acquired using 3T MRI with a 64-channel coil. Eighteen regions-of-interest (ROIs) were chosen around the cortex in one appropriate slice of the brain and the mean QSM-OEF for each ROI was obtained. The correlations of QSM-OEF among different clinical characteristics of the disease, as well as between the patients and normal subjects, were also investigated. RESULTS QSM-OEF was shown to be significantly higher in REPs (44.9 ± 5.8) than that in HS (41.9 ± 6.2) (p < 0.05). Mean QSM-OEF was statistically lower in the ipsilateral side (44.5 ± 6.6) compared to the contralateral side (46.4 ± 6.8) (P < 0.01). QSM-OEF was illustrated to have a strong positive correlation with the attack duration (r = 0.6), and a moderate negative correlation with the attack frequency (r = -0.3). Using an optimized support vector machine algorithm, we could predict the disease in subjects having abnormal OEF values in the brain-selected-ROIs with sensitivity, specificity, AUC, and the precision of 0.96, 1, 0.98, and 1, respectively. CONCLUSIONS The results of this study revealed that QSM-OEF of the REPs' brain is higher than that of HS, which indicates that QSM-OEF is associated with disease activity.
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Affiliation(s)
- Tayyebeh Ebrahimi
- Department of Medical Physics and Biomedical Engineering, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran; Department of Neuroimaging and Analysis, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran.
| | - Abbas Tafakhori
- Iranian Center of Neurological Research (ICNR), Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran.
| | - Hassan Hashemi
- Advanced Diagnostic and Interventional Radiology Research Center (ADIR), Tehran University of Medical Sciences, Tehran, Iran.
| | - Mohammad Ali Oghabian
- Department of Medical Physics and Biomedical Engineering, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran; Department of Neuroimaging and Analysis, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran; Research Center for Molecular and Cellular Imaging, Tehran University of Medical Science, Tehran, Iran.
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10
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Liu Y, Dong J, Song Q, Zhang N, Wang W, Gao B, Tian S, Dong C, Liang Z, Xie L, Miao Y. Correlation Between Cerebral Venous Oxygen Level and Cognitive Status in Patients With Alzheimer's Disease Using Quantitative Susceptibility Mapping. Front Neurosci 2021; 14:570848. [PMID: 33536866 PMCID: PMC7848136 DOI: 10.3389/fnins.2020.570848] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Accepted: 12/17/2020] [Indexed: 11/13/2022] Open
Abstract
Purpose To quantitatively assess the blood oxygen levels of the cerebral vein using quantitative susceptibility mapping (QSM), and to analyze the correlation between magnetic susceptibility value (MSV) and clinical laboratory indicators/cognitive scores in patients with Alzheimer's disease (AD). Materials and Methods Fifty-nine patients (21 males and 38 females) with clinically confirmed AD (AD group) and 22 control subjects (12 males, 10 females; CON group) were recruited. Clinical data and laboratory examination indexes were collected. All patients underwent Mini-mental State Examination, Montreal Cognitive Assessment, Clock Drawing Task, and Activity of Daily Living Scale test, as well as a routine MRI and enhanced gradient echo T2 star weighted angiography (ESWAN). Results Higher cerebral venous MSV was observed in AD group compared to CON group, significant differences were observed for bilateral thalamus veins and left dentate nucleus veins. The MSV of bilateral thalamus veins, bilateral internal cerebral veins, and bilateral dentate nucleus veins had significant negative correlation with Mini-mental State Examination score; the MSV of bilateral thalamus veins, bilateral dentate nucleus veins, right septal vein had a significant negative correlation with Montreal Cognitive Assessment scores; a significant negative correlation between the MSV of bilateral thalamus veins, left dentate nucleus vein, right septal vein and the Clock Drawing Task score; the MSV of bilateral thalamus veins, left dentate nucleus vein had a significant negative correlation with Activity of Daily Living Scale score. The MSV of left dentate nucleus vein was positively correlated with the course of the disease, the MSV of bilateral septal vein were positively correlated with the total cholesterol, and the MSV of left septal vein had a positive correlation with LDL. Conclusion Decreasing cerebral venous oxygen level in AD patients may affect cognitive status, and associated with the deterioration of the disease in AD patients.
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Affiliation(s)
- YangYingQiu Liu
- Department of Radiology, First Affiliated Hospital of Dalian Medical University, Dalian, China
| | - JunYi Dong
- Department of Radiology, First Affiliated Hospital of Dalian Medical University, Dalian, China
| | - QingWei Song
- Department of Radiology, First Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Nan Zhang
- Department of Radiology, First Affiliated Hospital of Dalian Medical University, Dalian, China
| | - WeiWei Wang
- Department of Radiology, First Affiliated Hospital of Dalian Medical University, Dalian, China
| | - BingBing Gao
- Department of Radiology, First Affiliated Hospital of Dalian Medical University, Dalian, China
| | - ShiYun Tian
- Department of Radiology, First Affiliated Hospital of Dalian Medical University, Dalian, China
| | - ChunBo Dong
- Department of Neurology, First Affiliated Hospital of Dalian Medical University, Dalian, China
| | - ZhanHua Liang
- Department of Neurology, First Affiliated Hospital of Dalian Medical University, Dalian, China
| | - LiZhi Xie
- GE Healthcare, MR Research China, Beijing, China
| | - YanWei Miao
- Department of Radiology, First Affiliated Hospital of Dalian Medical University, Dalian, China
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12
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Fan AP, Khalil AA, Fiebach JB, Zaharchuk G, Villringer A, Villringer K, Gauthier CJ. Elevated brain oxygen extraction fraction measured by MRI susceptibility relates to perfusion status in acute ischemic stroke. J Cereb Blood Flow Metab 2020; 40:539-551. [PMID: 30732551 PMCID: PMC7026852 DOI: 10.1177/0271678x19827944] [Citation(s) in RCA: 45] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Recent clinical trials of new revascularization therapies in acute ischemic stroke have highlighted the importance of physiological imaging to identify optimal treatments for patients. Oxygen extraction fraction (OEF) is a hallmark of at-risk tissue in stroke, and can be quantified from the susceptibility effect of deoxyhemoglobin molecules in venous blood on MRI phase scans. We measured OEF within cerebral veins using advanced quantitative susceptibility mapping (QSM) MRI reconstructions in 20 acute stroke patients. Absolute OEF was elevated in the affected (29.3 ± 3.4%) versus the contralateral hemisphere (25.5 ± 3.1%) of patients with large diffusion-perfusion lesion mismatch (P = 0.032). In these patients, OEF negatively correlated with relative CBF measured by dynamic susceptibility contrast MRI (P = 0.004), suggesting compensation for reduced flow. Patients with perfusion-diffusion match or no hypo-perfusion showed less OEF difference between hemispheres. Nine patients received longitudinal assessment and showed OEF ratio (affected to contralateral) of 1.2 ± 0.1 at baseline that normalized (decreased) to 1.0 ± 0.1 at follow-up three days later (P = 0.03). Our feasibility study demonstrates that QSM MRI can non-invasively quantify OEF in stroke patients, relates to perfusion status, and is sensitive to OEF changes over time. Clinical trial registration: Longitudinal MRI examinations of patients with brain ischemia and blood brain barrier permeability; clinicaltrials.org :NCT02077582.
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Affiliation(s)
- Audrey P Fan
- Department of Radiology, Stanford University, Stanford, CA, USA
| | - Ahmed A Khalil
- Center for Stroke Research Berlin, Charité Universitätsmedizin Berlin, Berlin, Germany.,Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany.,Berlin School of Mind and Brain, Humboldt-Universitaet zu Berlin, Berlin, Germany
| | - Jochen B Fiebach
- Center for Stroke Research Berlin, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Greg Zaharchuk
- Department of Radiology, Stanford University, Stanford, CA, USA
| | - Arno Villringer
- Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany.,Berlin School of Mind and Brain, Humboldt-Universitaet zu Berlin, Berlin, Germany
| | - Kersten Villringer
- Center for Stroke Research Berlin, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Claudine J Gauthier
- Department of Physics, Concordia University, Montreal, Canada.,Montreal Heart Institute, Montreal, Canada
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13
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Munakomi S. Determining Oxygen Extraction Fraction in Acute Infarction. World Neurosurg 2019; 125:555. [DOI: 10.1016/j.wneu.2019.01.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2018] [Revised: 12/30/2018] [Accepted: 01/02/2019] [Indexed: 11/27/2022]
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14
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Munakomi S. Reader response: The systolic blood pressure sweet spot after intracerebral hemorrhage: 130 mm Hg? Neurology 2019; 92:774-775. [PMID: 30988088 DOI: 10.1212/wnl.0000000000007309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Leatherday C, Dehkharghani S, Nahab F, Allen JW, Wu J, Hu R, Qiu D. Cerebral MR oximetry during acetazolamide augmentation: Beyond cerebrovascular reactivity in hemodynamic failure. J Magn Reson Imaging 2018; 50:175-182. [PMID: 30390367 DOI: 10.1002/jmri.26546] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2018] [Revised: 10/02/2018] [Accepted: 10/02/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Oxygen extraction fraction (OEF) elevation predicts increased ischemic stroke incidence among patients with carotid steno-occlusive disease, and can be estimated from quantitative susceptibility mapping (QSM) MRI. PURPOSE To explore QSM oximetry during acetazolamide (ACZ) challenge, hypothesizing that detectable OEF alterations will reflect hemodynamic compromise in unilateral cerebrovascular disease (CVD) patients. STUDY TYPE Retrospective. SUBJECTS Fourteen unilateral CVD patients, and 24 healthy controls (HC). FIELD STRENGTH/SEQUENCE Multiecho gradient echo (GRE) and T1 -weighted images at 3T. ASSESSMENT We constructed QSM images and R2* maps from multiecho GRE images. QSM-OEF maps were generated from the susceptibility difference between venous blood and background brain tissue. Intrasubject diseased/contralateral hemisphere OEF ratios in the middle cerebral artery (MCA) territories were calculated. Intravascular susceptibility in the straight sinus (SS) and MCA was also measured. STATISTICAL TESTS The result significance was determined using t-tests and Pearson's correlation. RESULTS Mean and standard deviation for the patient diseased/contralateral OEF ratios were 1.15 ± 0.14 at baseline and 1.23 ± 0.17 post-ACZ. Disease group R2* ratios were 0.95 ± 0.05 at baseline and 1.03 ± 0.08 post-ACZ. Left/right OEF and R2* ratios for the HC group were 0.98 ± 0.06 and 0.99 ± 0.038, respectively. Susceptibility (ppb) in the SS and MCA in patients was 162.63 ± 35.4 and -22.33 ± 13.70, respectively, at baseline, 124.56 ± 37.43 and -19.27 ± 23.14 post-ACZ. The HC group SS and MCA susceptibility was 146.10 ± 24.79 and -19.59 ± 12.37, respectively. Patient group OEF ratios were greater than 1.0 before and after ACZ challenge (P < 0.01 and < 0.001, respectively, one-sample t-test), and were greater than HC ratios (P < 0.001 unpaired t-test). OEF and R2* ratios increased from baseline to post-ACZ (P = 0.024, 0.004, respectively, paired t-test). Detectable blood oxygenation change was confirmed by finding SS susceptibility decreased from baseline to post-ACZ (P < 0.001, paired t-test), while MCA susceptibility did not change significantly (P = 0.67, paired t-test). DATA CONCLUSION These results suggest QSM is sensitive to dynamic OEF modulation during hemodynamic augmentation. LEVEL OF EVIDENCE 3 Technical Efficacy: Stage 3 J. Magn. Reson. Imaging 2019;50:175-182.
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Affiliation(s)
| | | | - Fadi Nahab
- Neurology, Emory University, Atlanta, Georgia, USA
| | - Jason W Allen
- Radiology and Imaging Sciences, Emory University, Atlanta, Georgia, USA.,Neurology, Emory University, Atlanta, Georgia, USA
| | - Junjie Wu
- Radiology and Imaging Sciences, Emory University, Atlanta, Georgia, USA
| | - Ranliang Hu
- Radiology and Imaging Sciences, Emory University, Atlanta, Georgia, USA
| | - Deqiang Qiu
- Radiology and Imaging Sciences, Emory University, Atlanta, Georgia, USA
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Li L, Liu MS, Li GQ, Zheng Y, Guo TL, Kang X, Yuan MT. Susceptibility-weighted Imaging in Thrombolytic Therapy of Acute Ischemic Stroke. Chin Med J (Engl) 2018; 130:2489-2497. [PMID: 29052571 PMCID: PMC5684633 DOI: 10.4103/0366-6999.216401] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023] Open
Abstract
Objective: To provide a comprehensive and latest overview of susceptibility-weighted imaging (SWI) in the application of thrombolysis in acute ischemic stroke, and to update the decision-making effect and clinical value of SWI on identifying stroke patients suitable for thrombolytic therapy and possible benefits and risks followed. Data Sources: Literatures referred to this review were collected from PubMed, Medline, and EMBASE published till May 2017, using the search terms including susceptibility-weighted imaging, gradient-echo, T2*, thrombolysis, recombinant tissue plasminogen activator (rt-PA), thrombolytic therapy, and stroke. Study Selection: Papers in English or with available English abstracts were considered, with no limitation of study design. References were also identified from the bibliographies of identified articles and the authors’ files. Results: SWI is of guiding significance for thrombolytic therapy in stroke patients, it can predict the location and length of thrombus and ischemic penumbra. It is worthy of noting that susceptibility vessel sign (SVS) on SWI can be used to predict recanalization after thrombolytic therapy and whether it is better to implement endovascular thrombolectomy in combination or alone. SWI is sensitive in detecting cerebral microbleed (CMB), and CMB might not be a contraindication for thrombolytic therapy, yet CMBs in multiple foci could possibly be related to intracranial hemorrhage (ICH) after thrombolysis. SVS and CMB on SWI sequence are of instructive value in performing antiplatelet therapy after thrombolytic therapy. Cerebral venous change on SWI is related to lower recanalization rate and poor outcome after thrombolysis. Conclusions: It seems that SWI can be applied to guide individualized thrombolytic therapies and assist clinicians in making better decisions by weighing benefits and risks. However, there still exist controversies about the relationship between signs on SWI and thrombolytic therapy.
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Affiliation(s)
- Lin Li
- Department of Neurology, The First Affiliated Hospital, Chongqing Medical University, Chongqing 400016, China
| | - Ming-Su Liu
- Department of Neurology, The First Affiliated Hospital, Chongqing Medical University, Chongqing 400016, China
| | - Guang-Qin Li
- Department of Neurology, The First Affiliated Hospital, Chongqing Medical University, Chongqing 400016, China
| | - Yang Zheng
- Department of Neurology, The First Affiliated Hospital, Chongqing Medical University, Chongqing 400016, China
| | - Tong-Li Guo
- Department of Neurology, The First Affiliated Hospital, Chongqing Medical University, Chongqing 400016, China
| | - Xin Kang
- Department of Neurology, The First Affiliated Hospital, Chongqing Medical University, Chongqing 400016, China
| | - Mao-Ting Yuan
- Department of Neurology, The First Affiliated Hospital, Chongqing Medical University, Chongqing 400016, China
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17
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Chen JJ. Functional MRI of brain physiology in aging and neurodegenerative diseases. Neuroimage 2018; 187:209-225. [PMID: 29793062 DOI: 10.1016/j.neuroimage.2018.05.050] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2017] [Revised: 05/16/2018] [Accepted: 05/20/2018] [Indexed: 12/14/2022] Open
Abstract
Brain aging and associated neurodegeneration constitute a major societal challenge as well as one for the neuroimaging community. A full understanding of the physiological mechanisms underlying neurodegeneration still eludes medical researchers, fuelling the development of in vivo neuroimaging markers. Hence it is increasingly recognized that our understanding of neurodegenerative processes likely will depend upon the available information provided by imaging techniques. At the same time, the imaging techniques are often developed in response to the desire to observe certain physiological processes. In this context, functional MRI (fMRI), which has for decades provided information on neuronal activity, has evolved into a large family of techniques well suited for in vivo observations of brain physiology. Given the rapid technical advances in fMRI in recent years, this review aims to summarize the physiological basis of fMRI observations in healthy aging as well as in age-related neurodegeneration. This review focuses on in-vivo human brain imaging studies in this review and on disease features that can be imaged using fMRI methods. In addition to providing detailed literature summaries, this review also discusses future directions in the study of brain physiology using fMRI in the clinical setting.
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Affiliation(s)
- J Jean Chen
- Rotman Research Institute at Baycrest Centre, Canada; Department of Medical Biophysics, University of Toronto, Canada.
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18
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Uwano I, Kudo K, Sato R, Ogasawara K, Kameda H, Nomura JI, Mori F, Yamashita F, Ito K, Yoshioka K, Sasaki M. Noninvasive Assessment of Oxygen Extraction Fraction in Chronic Ischemia Using Quantitative Susceptibility Mapping at 7 Tesla. Stroke 2017; 48:2136-2141. [DOI: 10.1161/strokeaha.117.017166] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2017] [Revised: 04/18/2017] [Accepted: 05/30/2017] [Indexed: 11/16/2022]
Affiliation(s)
- Ikuko Uwano
- From the Division of Ultrahigh Field MRI, Institute for Biomedical Sciences (I.U., K.K., H.K., F.M., F.Y., K.I., M.S.), Department of Neurosurgery (K.O., J.N.), and Department of Radiology (K.Y.), Iwate Medical University, Japan; Department of Diagnostic and Interventional Radiology, Hokkaido University Hospital, Sapporo, Japan (K.K., H.K.); and Research and Development Group, Hitachi Ltd, Tokyo, Japan (R.S.)
| | - Kohsuke Kudo
- From the Division of Ultrahigh Field MRI, Institute for Biomedical Sciences (I.U., K.K., H.K., F.M., F.Y., K.I., M.S.), Department of Neurosurgery (K.O., J.N.), and Department of Radiology (K.Y.), Iwate Medical University, Japan; Department of Diagnostic and Interventional Radiology, Hokkaido University Hospital, Sapporo, Japan (K.K., H.K.); and Research and Development Group, Hitachi Ltd, Tokyo, Japan (R.S.)
| | - Ryota Sato
- From the Division of Ultrahigh Field MRI, Institute for Biomedical Sciences (I.U., K.K., H.K., F.M., F.Y., K.I., M.S.), Department of Neurosurgery (K.O., J.N.), and Department of Radiology (K.Y.), Iwate Medical University, Japan; Department of Diagnostic and Interventional Radiology, Hokkaido University Hospital, Sapporo, Japan (K.K., H.K.); and Research and Development Group, Hitachi Ltd, Tokyo, Japan (R.S.)
| | - Kuniaki Ogasawara
- From the Division of Ultrahigh Field MRI, Institute for Biomedical Sciences (I.U., K.K., H.K., F.M., F.Y., K.I., M.S.), Department of Neurosurgery (K.O., J.N.), and Department of Radiology (K.Y.), Iwate Medical University, Japan; Department of Diagnostic and Interventional Radiology, Hokkaido University Hospital, Sapporo, Japan (K.K., H.K.); and Research and Development Group, Hitachi Ltd, Tokyo, Japan (R.S.)
| | - Hiroyuki Kameda
- From the Division of Ultrahigh Field MRI, Institute for Biomedical Sciences (I.U., K.K., H.K., F.M., F.Y., K.I., M.S.), Department of Neurosurgery (K.O., J.N.), and Department of Radiology (K.Y.), Iwate Medical University, Japan; Department of Diagnostic and Interventional Radiology, Hokkaido University Hospital, Sapporo, Japan (K.K., H.K.); and Research and Development Group, Hitachi Ltd, Tokyo, Japan (R.S.)
| | - Jun-ichi Nomura
- From the Division of Ultrahigh Field MRI, Institute for Biomedical Sciences (I.U., K.K., H.K., F.M., F.Y., K.I., M.S.), Department of Neurosurgery (K.O., J.N.), and Department of Radiology (K.Y.), Iwate Medical University, Japan; Department of Diagnostic and Interventional Radiology, Hokkaido University Hospital, Sapporo, Japan (K.K., H.K.); and Research and Development Group, Hitachi Ltd, Tokyo, Japan (R.S.)
| | - Futoshi Mori
- From the Division of Ultrahigh Field MRI, Institute for Biomedical Sciences (I.U., K.K., H.K., F.M., F.Y., K.I., M.S.), Department of Neurosurgery (K.O., J.N.), and Department of Radiology (K.Y.), Iwate Medical University, Japan; Department of Diagnostic and Interventional Radiology, Hokkaido University Hospital, Sapporo, Japan (K.K., H.K.); and Research and Development Group, Hitachi Ltd, Tokyo, Japan (R.S.)
| | - Fumio Yamashita
- From the Division of Ultrahigh Field MRI, Institute for Biomedical Sciences (I.U., K.K., H.K., F.M., F.Y., K.I., M.S.), Department of Neurosurgery (K.O., J.N.), and Department of Radiology (K.Y.), Iwate Medical University, Japan; Department of Diagnostic and Interventional Radiology, Hokkaido University Hospital, Sapporo, Japan (K.K., H.K.); and Research and Development Group, Hitachi Ltd, Tokyo, Japan (R.S.)
| | - Kenji Ito
- From the Division of Ultrahigh Field MRI, Institute for Biomedical Sciences (I.U., K.K., H.K., F.M., F.Y., K.I., M.S.), Department of Neurosurgery (K.O., J.N.), and Department of Radiology (K.Y.), Iwate Medical University, Japan; Department of Diagnostic and Interventional Radiology, Hokkaido University Hospital, Sapporo, Japan (K.K., H.K.); and Research and Development Group, Hitachi Ltd, Tokyo, Japan (R.S.)
| | - Kunihiro Yoshioka
- From the Division of Ultrahigh Field MRI, Institute for Biomedical Sciences (I.U., K.K., H.K., F.M., F.Y., K.I., M.S.), Department of Neurosurgery (K.O., J.N.), and Department of Radiology (K.Y.), Iwate Medical University, Japan; Department of Diagnostic and Interventional Radiology, Hokkaido University Hospital, Sapporo, Japan (K.K., H.K.); and Research and Development Group, Hitachi Ltd, Tokyo, Japan (R.S.)
| | - Makoto Sasaki
- From the Division of Ultrahigh Field MRI, Institute for Biomedical Sciences (I.U., K.K., H.K., F.M., F.Y., K.I., M.S.), Department of Neurosurgery (K.O., J.N.), and Department of Radiology (K.Y.), Iwate Medical University, Japan; Department of Diagnostic and Interventional Radiology, Hokkaido University Hospital, Sapporo, Japan (K.K., H.K.); and Research and Development Group, Hitachi Ltd, Tokyo, Japan (R.S.)
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Zhang X, Zhang S, Chen Q, Ding W, Campbell BCV, Lou M. Ipsilateral Prominent Thalamostriate Vein on Susceptibility-Weighted Imaging Predicts Poor Outcome after Intravenous Thrombolysis in Acute Ischemic Stroke. AJNR Am J Neuroradiol 2017; 38:875-881. [PMID: 28302608 DOI: 10.3174/ajnr.a5135] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2016] [Accepted: 12/30/2016] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE The impact of deep cerebral veins on neurologic outcome after intravenous thrombolysis in patients with acute ischemic stroke is unclear. We investigated the relationship between the appearance of deep cerebral veins on susceptibility-weighted imaging and neurologic outcome in patients who underwent thrombolysis. MATERIALS AND METHODS We retrospectively analyzed 109 consecutive patients with acute ischemic stroke who had pretreatment SWI and received intravenous thrombolysis within 6 hours. We calculated the signal difference ratio (defined as the relative difference in signal intensity between the ipsilateral and contralateral veins) of the thalamostriate vein, septal vein, and internal cerebral vein on pretreatment SWI. RESULTS Only the signal difference ratio of the thalamostriate vein was significantly associated with poor outcome (3-month modified Rankin Scale score > 2, P = .008). The optimal threshold was relative hypointensity of the ipsilateral vein of >4.8% (sensitivity of 53.7% and specificity of 80.9%). We defined a signal difference ratio of the thalamostriate vein of ≥5% as an ipsilateral prominent thalamostriate vein. Patients with an ipsilateral prominent thalamostriate vein were more likely to have poor outcome (OR = 3.66; 95% CI, 1.25-10.68; P = .02) and a lower rate of successful reperfusion (reperfusion rate of ≥70%; OR = 0.35; 95% CI, 0.13-0.92; P = .03), compared with those without an ipsilateral prominent thalamostriate vein. However, patients with an ipsilateral prominent thalamostriate vein were still less likely to experience poor outcome when reperfusion was achieved compared with when reperfusion did not occur (80.0% versus 44.4%, P = .04). CONCLUSIONS A pretreatment ipsilateral prominent thalamostriate vein was associated with reduced reperfusion after thrombolysis and poor outcome. More intensive reperfusion approaches may be required for patients with an ipsilateral prominent thalamostriate vein.
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Affiliation(s)
- X Zhang
- From the Departments of Neurology (X.Z., S.Z., Q.C., M.L.)
| | - S Zhang
- From the Departments of Neurology (X.Z., S.Z., Q.C., M.L.)
| | - Q Chen
- From the Departments of Neurology (X.Z., S.Z., Q.C., M.L.)
| | - W Ding
- Radiology (W.D.), the Second Affiliated Hospital of Zhejiang University, School of Medicine, Hangzhou, China
| | - B C V Campbell
- Department of Neurology (B.C.V.C.), Royal Melbourne Hospital, Grattan St, Parkville, Victoria, Australia
| | - M Lou
- From the Departments of Neurology (X.Z., S.Z., Q.C., M.L.)
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20
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Luo Y, Gong Z, Zhou Y, Chang B, Chai C, Liu T, Han Y, Wang M, Qian T, Haacke EM, Xia S. Increased susceptibility of asymmetrically prominent cortical veins correlates with misery perfusion in patients with occlusion of the middle cerebral artery. Eur Radiol 2016; 27:2381-2390. [PMID: 27655300 DOI: 10.1007/s00330-016-4593-y] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2016] [Revised: 08/09/2016] [Accepted: 08/30/2016] [Indexed: 03/06/2023]
Abstract
OBJECTIVES To evaluate tissue perfusion and venous susceptibility in ischaemic stroke patients as a means to predict clinical status and early prognosis. METHODS A retrospective study of 51 ischaemic stroke patients were enrolled in this study. Susceptibility, perfusion and National Institute of Health stroke scale (NIHSS) were compared between patients with and without asymmetrically prominent cortical veins (APCVs). The correlation between susceptibility, perfusion and NIHSS was performed. RESULTS Compared to patients without APCVs, the age of patients with APCVs was statistically older (p = 0.017). Patients with APCVs at discharge showed clinical deterioration in their NIHSS. Mean transit time (MTT), time to peak (TTP) and cerebral blood flow (CBF) in the stroke hemisphere were statistically delayed/decreased in patients with and without APCVs (all p < 0.05). In patients with APCVs, the changes in susceptibility positively correlated with increases in MTT and TTP (p < 0.05). Susceptibility and TTP positively correlated and CBF negatively correlated with NIHSS both at admission and discharge (p < 0.05). CONCLUSIONS Patients with APCVs have a tendency of deterioration. The presence of APCVs indicates the tissue has increased oxygen extraction fraction. Increased susceptibility from APCVs positively correlated with the delayed MTT and TTP, which reflects the clinical status at admission and predicts an early prognosis. KEY POINTS • Patients with and without APCVs have similar misery perfusion. • Patients with APCVs have a tendency of deterioration compared to those without. • The presence of APCVs indicated the tissue has increased oxygen extraction fraction. • Increased susceptibility from APCVs positively correlated with the MTT and TTP. • Increased susceptibility from APCVs reflected the clinical status at admission.
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Affiliation(s)
- Yu Luo
- Radiology Department, Branch of Shanghai First Hospital No.1878, North Sichuan Road, Shanghai, China, 200081
| | - Zhongying Gong
- Neurological Department, Tianjin First Central Hospital, Tianjin, China, 300192
| | - Yongming Zhou
- Radiology Department, Branch of Shanghai First Hospital No.1878, North Sichuan Road, Shanghai, China, 200081
| | - Binge Chang
- Neurosurgery Department, Tianjin First Central Hospital, Tianjin, China, 300192
| | - Chao Chai
- Radiology Department, Tianjin First Central Hospital, Tianjin, China, 300192
| | - Taiyuan Liu
- Radiology Department, Zhengzhou University People's Hospital, Zhengzhou, China, 450003
| | - Yanhong Han
- Radiology Department, Zhengzhou University People's Hospital, Zhengzhou, China, 450003
| | - Meiyun Wang
- Radiology Department, Zhengzhou University People's Hospital, Zhengzhou, China, 450003.
| | - Tianyi Qian
- Siemens Healthcare, MR collaboration, Northeast Asia, No.7, Wangjing Zhonghuan South Road, Beijing, China, 100102
| | - E Mark Haacke
- Radiology Department, Wayne State University, Detroit, MI, USA
| | - Shuang Xia
- Radiology Department, Tianjin First Central Hospital, Tianjin, China, 300192.
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Kudo K, Liu T, Murakami T, Goodwin J, Uwano I, Yamashita F, Higuchi S, Wang Y, Ogasawara K, Ogawa A, Sasaki M. Oxygen extraction fraction measurement using quantitative susceptibility mapping: Comparison with positron emission tomography. J Cereb Blood Flow Metab 2016; 36:1424-33. [PMID: 26661168 PMCID: PMC4976745 DOI: 10.1177/0271678x15606713] [Citation(s) in RCA: 75] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2015] [Accepted: 08/03/2015] [Indexed: 11/15/2022]
Abstract
The purposes of this study are to establish oxygen extraction fraction (OEF) measurements using quantitative susceptibility mapping (QSM) of magnetic resonance imaging (MRI), and to compare QSM-OEF data with the gold standard (15)O positron emission tomography (PET). Twenty-six patients with chronic unilateral internal carotid artery or middle cerebral artery stenosis or occlusion, and 15 normal subjects were included. MRI scans were conducted using a 3.0 Tesla scanner with a three-dimensional spoiled gradient recalled sequence. QSM images were created using the morphology-enabled dipole inversion method, and OEF maps were generated from QSM images using extraction of venous susceptibility induced by deoxygenated hemoglobin. Significant correlation of relative OEF ratio to contra-lateral hemisphere between QSM-OEF and PET-OEF was observed (r = 0.62, p < 0.001). The local (intra-section) correlation was also significant (r = 0.52, p < 0.001) in patients with increased PET-OEF. The sensitivity and specificity of OEF increase in QSM was 0.63 (5/8) and 0.89 (16/18), respectively, in comparison with PET. In conclusion, good correlation was achieved between QSM-OEF and PET-OEF in the identification of elevated OEF in affected hemispheres of patients with unilateral chronic steno-occlusive disease.
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Affiliation(s)
- Kohsuke Kudo
- Division of Ultra-High Field MRI, Iwate Medical University, Japan Department of Diagnostic and Interventional Radiology, Hokkaido University Hospital, Japan
| | - Tian Liu
- Departments of Radiology, Weill Cornell Medical College, New York, NY, USA MedImageMetric LLC, New York, NY, USA
| | | | - Jonathan Goodwin
- Division of Ultra-High Field MRI, Iwate Medical University, Japan
| | - Ikuko Uwano
- Division of Ultra-High Field MRI, Iwate Medical University, Japan
| | - Fumio Yamashita
- Division of Ultra-High Field MRI, Iwate Medical University, Japan
| | - Satomi Higuchi
- Division of Ultra-High Field MRI, Iwate Medical University, Japan
| | - Yi Wang
- Departments of Radiology, Weill Cornell Medical College, New York, NY, USA
| | | | - Akira Ogawa
- Department of Neurosurgery, Iwate Medical University, Japan
| | - Makoto Sasaki
- Division of Ultra-High Field MRI, Iwate Medical University, Japan
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22
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Wu ML, Chang HC, Chao TC, Chen NK. Efficient imaging of midbrain nuclei using inverse double-echo steady-state acquisition. Med Phys 2016; 42:4367-74. [PMID: 26133633 DOI: 10.1118/1.4922402] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
PURPOSE Imaging of midbrain nuclei using T2- or T2*-weighted MRI often entails long echo time, leading to long scan time. In this study, an inverse double-echo steady-state (iDESS) technique is proposed for efficiently depicting midbrain nuclei. METHODS Thirteen healthy subjects participated in this study. iDESS was performed along with two sets of T2*-weighted spoiled gradient-echo images (SPGR1, with scan time identical to iDESS and SPGR2, using clinical scanning parameters as a reference standard) for comparison. Generation of iDESS composite images combining two echo signals was optimized for maximal contrast-to-noise ratio (CNR) between the red nuclei and surrounding tissues. Signal-to-noise ratios (SNRs) were calculated from the occipital lobe. Comparison was also made using phase-enhanced images as in standard susceptibility-weighted imaging (SWI). RESULTS The iDESS images present significantly higher SNR efficiency (171.3) than SPGR1 (158.7, p = 0.013) and SPGR2 (95.5, p < 10(-8)). iDESS CNR efficiency (19.2) is also significantly greater than SPGR1 (6.9, p < 10(-6)) and SPGR2 (14.3, p = 0.0016). Compared with DESS, iDESS provides further advantage on enhanced phase information and hence improved contrast on SWI-processed images. CONCLUSIONS iDESS efficiently depicts midbrain nuclei with improved CNR efficiency, increased SNR efficiency, and reduced scan time and is less prone to susceptibility signal loss from air-tissue interfaces.
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Affiliation(s)
- Ming-Long Wu
- Department of Computer Science and Information Engineering, National Cheng Kung University, No. 1, University Road, Tainan 70101, Taiwan and Institute of Medical Informatics, National Cheng Kung University, No. 1, University Road, Tainan 70101, Taiwan
| | - Hing-Chiu Chang
- Brain Imaging and Analysis Center, Duke University Medical Center, 2424 Erwin Road, Suite 501, Durham, North Carolina 27705 and Department of Diagnostic Radiology, The University of Hong Kong, Room 406, Block K, Queen Mary Hospital, Pok Fu Lam Road, Hong Kong
| | - Tzu-Cheng Chao
- Department of Computer Science and Information Engineering, National Cheng Kung University, No. 1, University Road, Tainan 70101, Taiwan and Institute of Medical Informatics, National Cheng Kung University, No. 1, University Road, Tainan 70101, Taiwan
| | - Nan-Kuei Chen
- Brain Imaging and Analysis Center, Duke University Medical Center, 2424 Erwin Road, Suite 501, Durham, North Carolina 27705
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Zhang Z, Hallac RR, Peschke P, Mason RP. A noninvasive tumor oxygenation imaging strategy using magnetic resonance imaging of endogenous blood and tissue water. Magn Reson Med 2016; 71:561-9. [PMID: 23447121 DOI: 10.1002/mrm.24691] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
PURPOSE To present a novel imaging strategy for noninvasive measurement of tumor oxygenation using MR imaging of endogenous blood and tissue water. THEORY AND METHODS The proposed approach for oxygen partial pressure (pO2) estimation is based on intravoxel incoherent motion diffusion MRI and the dependence of the blood R2 relaxation rate on the inter-echo spacing measured using a multiple spin-echo Carr-Purcell-Meiboom-Gill sequence and weak-field diffusion model. The accuracy of the approach was validated by comparison with (19)F MRI oximetry. RESULTS The results in eight rats at 4.7 T showed that tumors have longer T1 (1980 ± 186 ms) and T2 (59 ± 9 ms) relaxation times, heterogeneous blood volume fraction (0.23 ± 0.1), oxygen saturation level (Y) (0.53 ± 0.12), and pO2 (36 ± 15 mmHg) distributions compared with normal muscle (T1 1480 ± 86 ms, T2 29 ± 2 ms, blood volume fraction 0.22 ± 0.03, Y 0.49 ± 0.06, and pO2 39 ± 5 mmHg). pO2 estimates based on the novel (1)H approach were essentially identical with (19)F observations. CONCLUSION The study indicates that noninvasive measurement of tumor pO2 using (1)H MRI derived multiparametric maps is feasible and could become a valuable tool to evaluate tumor hypoxia.
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Affiliation(s)
- Zhongwei Zhang
- Department of Radiology, The University of Texas Southwestern Medical Center, Dallas, Texas, USA
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Liu Z, Li Y. Cortical Cerebral Blood Flow, Oxygen Extraction Fraction, and Metabolic Rate in Patients with Middle Cerebral Artery Stenosis or Acute Stroke. AJNR Am J Neuroradiol 2015; 37:607-14. [PMID: 26680459 DOI: 10.3174/ajnr.a4624] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2015] [Accepted: 08/09/2015] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE With the advances of magnetic resonance technology, the CBF, oxygen extraction fraction, and cerebral metabolic rate of oxygen can be measured in MRI. Our aim was to measure the CBF, oxygen extraction fraction, and cerebral metabolic rate of oxygen use in patients with different severities of middle cerebral artery stenosis or acute stroke by using the arterial spin-labeling and susceptibility-weighted imaging techniques. MATERIALS AND METHODS Fifty-seven patients with MCA stenosis or acute stroke were recruited and classified into 4 groups: mild MCA stenosis (group 1), severe MCA stenosis (group 2), occluded MCA (group 3), and acute stroke (group 4). Arterial spin-labeling and SWI sequences were used to acquire CBF, oxygen extraction fraction, and cerebral metabolic rate of oxygen. RESULTS The oxygen extraction fraction in hemispheres with mild MCA stenosis (group 1) was remarkably higher than that in the contralateral hemisphere. In addition, hemispheres with severe MCA stenosis (group 2) had significantly lower CBF and a significantly higher oxygen extraction fraction than the contralateral hemisphere. Hemispheres with occluded MCA (group 3) or acute stroke (group 4) had a significantly lower CBF and cerebral metabolic rate of oxygen and a significantly higher oxygen extraction fraction than the contralateral hemisphere. CONCLUSIONS The oxygen extraction fraction gradually increased in groups 1-3. When this offset a decrease in CBF, the cerebral metabolic rate of oxygen remained at a normal level. An occluded MCA led to reduction in both the CBF and cerebral metabolic rate of oxygen. Moreover, the oxygen extraction fraction and cerebral metabolic rate of oxygen significantly increased and decreased, respectively, in the occluded MCA region during acute stroke.
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Affiliation(s)
- Z Liu
- From the Department of Medical Imaging (Z.L.), First Hospital of Nanchang City, The Third Affiliated Hospital of Nanchang University, Nanchang City, China
| | - Y Li
- Department of Preventive Medicine (Y.L.), Heze Medical College, HeZe, Shandong, China
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Goodwin JA, Kudo K, Shinohe Y, Higuchi S, Uwano I, Yamashita F, Sasaki M. Susceptibility-Weighted Phase Imaging and Oxygen Extraction Fraction Measurement during Sedation and Sedation Recovery using 7T MRI. J Neuroimaging 2014; 25:575-81. [DOI: 10.1111/jon.12192] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2013] [Revised: 08/01/2014] [Accepted: 09/13/2014] [Indexed: 11/29/2022] Open
Affiliation(s)
- Jonathan A. Goodwin
- Division of Ultrahigh Field MRI; Iwate Medical University; Iwate Japan
- Department of Radiology; Hokkaido University Hospital; Hokkaido Japan
| | - Kohsuke Kudo
- Division of Ultrahigh Field MRI; Iwate Medical University; Iwate Japan
- Department of Radiology; Hokkaido University Hospital; Hokkaido Japan
| | - Yutaka Shinohe
- Division of Dental Anesthesiology; Department of Oral and Maxillofacial Surgery; Iwate Medical University; Iwate Japan
| | - Satomi Higuchi
- Division of Ultrahigh Field MRI; Iwate Medical University; Iwate Japan
| | - Ikuko Uwano
- Division of Ultrahigh Field MRI; Iwate Medical University; Iwate Japan
| | - Fumio Yamashita
- Division of Ultrahigh Field MRI; Iwate Medical University; Iwate Japan
| | - Makoto Sasaki
- Division of Ultrahigh Field MRI; Iwate Medical University; Iwate Japan
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Xia S, Utriainen D, Tang J, Kou Z, Zheng G, Wang X, Shen W, Haacke EM, Lu G. Decreased oxygen saturation in asymmetrically prominent cortical veins in patients with cerebral ischemic stroke. Magn Reson Imaging 2014; 32:1272-6. [PMID: 25131626 DOI: 10.1016/j.mri.2014.08.012] [Citation(s) in RCA: 62] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2014] [Accepted: 08/08/2014] [Indexed: 01/28/2023]
Abstract
Decreased oxygen saturation in asymmetrically prominent cortical veins (APCV) seen in ischemic stroke has been hypothesized to correlate with an increase of de-oxygenated hemoglobin. Our goal is to quantify magnetic susceptibility to define APCV by establishing a cutoff above which the deoxyhemoglobin levels are considered abnormal. A retrospective study was conducted on 26 patients with acute ischemic stroke in one cerebral hemisphere that exhibited APCV with 30 age- and sex-matched healthy controls. Quantitative susceptibility mapping (QSM) was used to calculate the magnetic susceptibility of the cortical veins. A paired t-test was used to compare the susceptibility of the cortical veins in the left and right hemispheres for healthy controls as well as in the contralateral hemisphere for stroke patients with APCV. The change in oxygen saturation in the APCV relative to the contralateral side was calculated after thresholding the susceptibility using the mean plus two standard deviations of the contralateral side for each individual. The thresholded susceptibility value of the APCVs in the stroke hemisphere was 254±48 ppb which was significantly higher (p<0.05) than that in the contralateral hemisphere (123±12 ppb) and in healthy controls (125±8 ppb). There was a decrease of oxygen saturation in the APCV ranging from 16% to 44% relative to the veins of the contralateral hemisphere. In conclusion, APCV seen in SWI correspond to reduced levels of oxygen saturation and these abnormal veins can be identified using a susceptibility threshold on the QSM data.
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Affiliation(s)
- Shuang Xia
- Department of Radiology, Nanjing Jinling Hospital,Clinical School, Medical College, Nanjing University, 305 Eastern Zhongshan Rd. Nanjing, China 210002; Department of Radiology, Tianjin First Central Hospital, Tianjin 300192, China
| | - David Utriainen
- Department of Radiology, Magnetic Resonance Imaging Institute for Biomedical Research, Detroit, MI 48202
| | - Jin Tang
- Department of Radiology, Magnetic Resonance Imaging Institute for Biomedical Research, Detroit, MI 48202
| | - Zhifeng Kou
- Department of Radiology, Wayne State University, Detroit, MI 48201
| | - Gang Zheng
- Department of Radiology, Nanjing Jinling Hospital,Clinical School, Medical College, Nanjing University, 305 Eastern Zhongshan Rd. Nanjing, China 210002
| | - Xuesong Wang
- Department of Neurology, Tianjin First Central Hospital, Tianjin 300192, China
| | - Wen Shen
- Department of Radiology, Tianjin First Central Hospital, Tianjin 300192, China
| | - E Mark Haacke
- Department of Radiology, Magnetic Resonance Imaging Institute for Biomedical Research, Detroit, MI 48202; Department of Radiology, Wayne State University, Detroit, MI 48201
| | - Guangming Lu
- Department of Radiology, Nanjing Jinling Hospital,Clinical School, Medical College, Nanjing University, 305 Eastern Zhongshan Rd. Nanjing, China 210002.
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Gupta A, Baradaran H, Schweitzer AD, Kamel H, Pandya A, Delgado D, Wright D, Hurtado-Rua S, Wang Y, Sanelli PC. Oxygen extraction fraction and stroke risk in patients with carotid stenosis or occlusion: a systematic review and meta-analysis. AJNR Am J Neuroradiol 2014; 35:250-5. [PMID: 23945227 DOI: 10.3174/ajnr.a3668] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Increased oxygen extraction fraction on PET has been considered a risk factor for stroke in patients with carotid stenosis or occlusion, though the strength of this association has recently been questioned. We performed a systematic review and meta-analysis to summarize the association between increased oxygen extraction fraction and ipsilateral stroke risk. MATERIALS AND METHODS A comprehensive literature search was performed. We included studies with baseline PET oxygen extraction fraction testing, ipsilateral stroke as the primary outcome, and at least 1 year of follow-up. A meta-analysis was performed by use of a random-effects model. RESULTS After screening 2158 studies, 7 studies with 430 total patients with mean 30-month follow-up met inclusion criteria. We found that 6 of 7 studies were amenable to meta-analysis. Although 4 of the 6 studies independently did not reach statistical significance, meta-analysis revealed a significant positive relationship between abnormal oxygen extraction fraction and future ipsilateral stroke, with a pooled OR of 6.04 (95% CI, 2.58-14.12). There was no statistically significant difference in OR in the subgroup analyses according to testing method or disease site. CONCLUSIONS Abnormal oxygen extraction fraction remains a powerful predictor of stroke in carotid stenosis or occlusion and is a valuable reference standard to compare and validate MR imaging-based measures of brain oxygen metabolism. However, there is a need for further evaluation of oxygen extraction fraction testing in patients with high-grade but asymptomatic carotid disease.
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Affiliation(s)
- A Gupta
- From the Departments of Radiology (A.G., H.B., A.D.S., Y.W., P.C.S.)
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Inoue Y, Tanaka Y, Hata H, Hara T. Arterial spin-labeling evaluation of cerebrovascular reactivity to acetazolamide in healthy subjects. AJNR Am J Neuroradiol 2013; 35:1111-6. [PMID: 24371025 DOI: 10.3174/ajnr.a3815] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Arterial spin-labeling MR imaging permits safe, repeated CBF measurement. We investigated the potential and technical factors of arterial spin-labeling imaging in assessing cerebrovascular reactivity to acetazolamide. MATERIALS AND METHODS The regional CBF was measured in 8 healthy volunteers by use of a 3D pseudocontinuous arterial spin-labeling sequence. Arterial spin labeling imaging was performed at rest and every 2 minutes after intravenous acetazolamide injection. To evaluate repeatability, regional CBF measurements were repeated without acetazolamide within an imaging session and on a separate day. Additionally, arterial spin-labeling imaging was performed at rest and after acetazolamide injection with different postlabeling delays, and regional cerebrovascular reactivity was calculated. RESULTS The regional CBF started to increase immediately after acetazolamide injection and peaked at approximately 10 minutes, followed by a slow decrease. Favorable intrasession repeatability was demonstrated, especially when scanner tuning was omitted between scans. Rest regional CBF was slightly lower with a postlabeling delay of 2525 ms than with a postlabeling delay of 1525 ms, and the postlabeling delay-dependent difference was more evident for regional CBF after acetazolamide injection and regional cerebrovascular reactivity. CONCLUSIONS Arterial spin-labeling imaging allows evaluation of the distribution, magnitude, and time course of cerebrovascular response to acetazolamide. The influence of the postlabeling delay on the estimated cerebrovascular reactivity should be noted.
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Affiliation(s)
- Y Inoue
- From the Departments of Diagnostic Radiology (Y.I., T.H.)
| | - Y Tanaka
- Radiology (Y.T., H.H.), Kitasato University Hospital, Sagamihara, Kanagawa, Japan
| | - H Hata
- Radiology (Y.T., H.H.), Kitasato University Hospital, Sagamihara, Kanagawa, Japan
| | - T Hara
- From the Departments of Diagnostic Radiology (Y.I., T.H.)
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Pesaresi I, Sabato M, Desideri I, Puglioli M, Moretti P, Cosottini M. 3.0T MR investigation of CLIPPERS: Role of susceptibility weighted and perfusion weighted imaging. Magn Reson Imaging 2013; 31:1640-2. [DOI: 10.1016/j.mri.2013.06.012] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2013] [Revised: 06/25/2013] [Accepted: 06/26/2013] [Indexed: 10/26/2022]
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Jensen-Kondering U, Böhm R. Asymmetrically hypointense veins on T2*w imaging and susceptibility-weighted imaging in ischemic stroke. World J Radiol 2013; 5:156-165. [PMID: 23671751 PMCID: PMC3647207 DOI: 10.4329/wjr.v5.i4.156] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2012] [Accepted: 03/07/2013] [Indexed: 02/06/2023] Open
Abstract
AIM: To review the literature on the assessment of venous vessels to estimate the penumbra on T2*w imaging and susceptibility-weighted imaging (SWI).
METHODS: Literature that reported on the assessment of penumbra by T2*w imaging or SWI and used a validation method was included. PubMed and relevant stroke and magnetic resonance imaging (MRI) related conference abstracts were searched. Abstracts that had overlapping content with full text articles were excluded. The retrieved literature was scanned for further relevant references. Only clinical literature published in English was considered, patients with Moya-Moya syndrome were disregarded. Data is given as cumulative absolute and relative values, ranges are given where appropriate.
RESULTS: Forty-three publications including 1145 patients could be identified. T2*w imaging was used in 16 publications (627 patients), SWI in 26 publications (453 patients). Only one publication used both (65 patients). The cumulative presence of hypointense vessel sign was 54% (range 32%-100%) for T2* (668 patients) and 81% (range 34%-100%) for SWI (334 patients). There was rare mentioning of interrater agreement (6 publications, 210 patients) and reliability (1 publication, 20 patients) but the numbers reported ranged from good to excellent. In most publications (n = 22) perfusion MRI was used as a validation method (617 patients). More patients were scanned in the subacute than in the acute phase (596 patients vs 320 patients). Clinical outcome was reported in 13 publications (521 patients) but was not consistent.
CONCLUSION: The low presence of vessels signs on T2*w imaging makes SWI much more promising. More research is needed to obtain formal validation and quantification.
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