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Hoffmann AC, Ruel Y, Gnirs K, Papageorgiou S, Zilberstein L, Nahmani S, Boddaert N, Gaillot H. Brain perfusion magnetic resonance imaging using pseudocontinuous arterial spin labeling in 314 dogs and cats. J Vet Intern Med 2021; 35:2327-2341. [PMID: 34291497 PMCID: PMC8478041 DOI: 10.1111/jvim.16215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Revised: 06/17/2021] [Accepted: 06/22/2021] [Indexed: 11/30/2022] Open
Abstract
Background Arterial spin labeling (ASL) is a noninvasive brain perfusion magnetic resonance imaging (MRI) technique that has not been assessed in clinical veterinary medicine. Hypothesis/Objectives To test the feasibility of ASL using a 1.5 Tesla scanner and provide recommendations for optimal quantification of cerebral blood flow (CBF) in dogs and cats. Animals Three hundred fourteen prospectively selected client‐owned dogs and cats. Methods Each animal underwent brain MRI including morphological sequences and ≥1 ASL sequences using different sites of blood labeling and postlabeling delays (PLD). Calculated ASL success rates were compared. The CBF was quantified in animals that had morphologically normal brain MRI results and parameters of ASL optimization were investigated. Results Arterial spin labeling was easily implemented with an overall success rate of 95% in animals with normal brain MRI. Technical recommendations included (a) positioning of the imaging slab at the foramen magnum and (b) selected PLD of 1025 ms in cats and dogs <7 kg, 1525 ms in dogs 7 to 38 kg, and 2025 ms in dogs >38 kg. In 37 dogs, median optimal CBF in the cortex and thalamic nuclei were 114 and 95 mL/100 g/min, respectively. In 28 cats, median CBF in the cortex and thalamic nuclei were 113 and 114 mL/100 g/min, respectively. Conclusions and Clinical Importance Our survey of brain perfusion ASL‐MRI demonstrated the feasibility of ASL at 1.5 Tesla, suggested technical recommendations and provided CBF values that should be helpful in the characterization of various brain diseases in dogs and cats.
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Affiliation(s)
- Anne-Cécile Hoffmann
- Unit of Diagnostic Imaging, ADVETIA Veterinary Referral Hospital, Vélizy-Villacoublay, France
| | - Yannick Ruel
- Unit of Diagnostic Imaging, ADVETIA Veterinary Referral Hospital, Vélizy-Villacoublay, France
| | - Kirsten Gnirs
- Unit of Neurology, ADVETIA Veterinary Referral Hospital, Vélizy-Villacoublay, France
| | - Stella Papageorgiou
- Unit of Neurology, ADVETIA Veterinary Referral Hospital, Vélizy-Villacoublay, France
| | - Luca Zilberstein
- Unit of Anesthesiology-Analgesia, ADVETIA Veterinary Referral Hospital, Vélizy-Villacoublay, France
| | - Sarah Nahmani
- Paediatric Radiology Department, AP-HP, Hôpital Necker Enfants Malades, Université de Paris, Paris, France
| | - Nathalie Boddaert
- Paediatric Radiology Department, AP-HP, Hôpital Necker Enfants Malades, Université de Paris, Paris, France.,Universié de Paris, Institut Imagine INSERM U1163, Paris, France
| | - Hugues Gaillot
- Unit of Diagnostic Imaging, ADVETIA Veterinary Referral Hospital, Vélizy-Villacoublay, France
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Nam KW, Kim CK, Ko SB, Yoon BW, Yoo RE, Sohn CH. Regional Arterial Spin Labeling Perfusion Defect Is Associated With Early Ischemic Recurrence in Patients With a Transient Ischemic Attack. Stroke 2019; 51:186-192. [PMID: 31718505 DOI: 10.1161/strokeaha.119.026556] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background and Purpose- With the lack of confirmatory examinations, the distinction of a transient ischemic attack (TIA) from various TIA-mimicking diseases is difficult, particularly in diffusion-weighted imaging (DWI)-negative TIAs. In this study, we aimed to evaluate the relationship between arterial spin labeling (ASL) perfusion defects and early ischemic recurrence (FU-DWI [+]) in patients with DWI-negative TIAs. Methods- We assessed consecutive patients with a DWI-negative TIA within 24 hours of symptom onset, who underwent both ASL images and follow-up magnetic resonance imaging during the acute period. As markers of the ASL images, we evaluated the ASL perfusion defects in each hemisphere. Arterial transit artifact (ATA) and intraarterial high-intensity signal (IAS) were also rated as markers of collateral status and blood stagnation due to large vessel occlusion, respectively. Results- Among the 136 patients with a DWI-negative TIA, 33 patients had FU-DWI (+) lesions in 36 hemispheres. In the multivariable analysis, ASL defects remained an independent predictor of FU-DWI (+) (adjusted odds ratio, 13.94 [95% CI, 5.77-33.70], P<0.001). In the evaluation of the interactive relationship between ASL defects and ATA/IAS, the (ASL [+] ATA [-]) group showed the highest frequencies of FU-DWI (+) events (55.6%) with the highest adjusted odds ratio values (adjusted odds ratio, 14.86 [95% CI, 5.63-39.24], P<0.001), indicating a negative synergistic effect between the ASL defects and ATA. Meanwhile, the (ASL [+] IAS [+]) group showed higher frequencies of FU-DWI (+) and higher adjusted odds ratio values than those of the (ASL [+] IAS [-]) and (ASL [-] IAS [-]) groups, indicating a positive synergistic effect. Conclusions- We demonstrated that ASL perfusion defects were associated with ipsilateral FU-DWI (+) in patients with a DWI-negative TIA. Furthermore, this association was enhanced with IASs and attenuated with ATAs.
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Affiliation(s)
- Ki-Woong Nam
- From the Department of Neurology (K.-W.N., S.-B.K., B.-W.Y.), Seoul National University Hospital, Korea.,Seoul National University College of Medicine, Korea (K.-W.N., S.-B.K., B.-W.Y., C.-H.S.)
| | - Chi Kyung Kim
- Department of Neurology, Korea University Guro Hospital, Seoul (C.K.K.).,Korea University College of Medicine, Seoul (C.K.K.)
| | - Sang-Bae Ko
- From the Department of Neurology (K.-W.N., S.-B.K., B.-W.Y.), Seoul National University Hospital, Korea.,Seoul National University College of Medicine, Korea (K.-W.N., S.-B.K., B.-W.Y., C.-H.S.)
| | - Byung-Woo Yoon
- From the Department of Neurology (K.-W.N., S.-B.K., B.-W.Y.), Seoul National University Hospital, Korea.,Seoul National University College of Medicine, Korea (K.-W.N., S.-B.K., B.-W.Y., C.-H.S.)
| | - Roh-Eul Yoo
- Department of Radiology (R.-E.Y., C.-H.S.), Seoul National University Hospital, Korea
| | - Chul-Ho Sohn
- Department of Radiology (R.-E.Y., C.-H.S.), Seoul National University Hospital, Korea.,Seoul National University College of Medicine, Korea (K.-W.N., S.-B.K., B.-W.Y., C.-H.S.)
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van Os HJA, Mulder IA, van der Schaaf IC, Kappelle LJ, Velthuis BK, Broersen A, Vos JA, Terwindt GM, Schonewille W, Ferrari MD, Algra A, van Walderveen MAA, Wermer MJH. Role of atherosclerosis, clot extent, and penumbra volume in headache during ischemic stroke. Neurology 2016; 87:1124-30. [PMID: 27534709 DOI: 10.1212/wnl.0000000000003092] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2016] [Accepted: 06/01/2016] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To investigate the role of large vessel atherosclerosis, blood clot extent, and penumbra volume in relation to headache in ischemic stroke patients. METHODS In this cross-sectional study, we performed noncontrast CT, CT angiography (CTA), and CT perfusion (CTP) in 284 participants from the Dutch Acute Stroke Study and Leiden Stroke Cohort within 9 hours after ischemic stroke onset. We collected headache characteristics prospectively using a semi-structured questionnaire. Atherosclerosis was assessed by evaluating presence of plaques in extracranial and intracranial vessels and by quantifying intracranial carotid artery calcifications. Clot extent was estimated by the clot burden score on CTA and penumbra volume by CTP. We calculated risk ratios (RRs) with adjustments (aRR) for possible confounders using multivariable Poisson regression. RESULTS Headache during stroke was reported in 109/284 (38%) participants. Headache was less prevalent in patients with than in patients without atherosclerosis in the extracranial anterior circulation (35% vs 48%; RR 0.72; 95% confidence interval [CI] 0.54-0.97). Atherosclerosis in the intracranial arteries was also associated with less headache, but this association was not statistically significant. Penumbra volume (aRR 1.08; 95% CI 0.63-1.85) and clot extent (aRR 1.02; 95% CI 0.86-1.20) were not related with headache. CONCLUSIONS Headache in the early phase of ischemic stroke tends to occur less often in patients with atherosclerosis than in patients without atherosclerosis in the large cerebral arteries. This finding lends support to the hypothesis that vessel wall elasticity is a necessary contributing factor in the occurrence of headache during acute ischemic stroke.
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Affiliation(s)
- Hendrikus J A van Os
- From the Department of Neurology (H.J.A.v.O., I.A.M., G.M.T., M.D.F., M.J.H.W.) and Department of Radiology (M.A.A.v.W.), Division of Image Processing (A.B.), Leiden University Medical Center; Departments of Radiology (I.C.v.d.S., B.K.V.) and Neurology (L.J.K.), Department of Neurology and Neurosurgery, Brain Center Rudolf Magnus (A.A.), and Julius Center for Health Sciences and Primary Care (A.A.), University Medical Center Utrecht; and Department of Neurology (J.A.V., W.S.), St Antonius Hospital, Nieuwegein, Netherlands.
| | - Inge A Mulder
- From the Department of Neurology (H.J.A.v.O., I.A.M., G.M.T., M.D.F., M.J.H.W.) and Department of Radiology (M.A.A.v.W.), Division of Image Processing (A.B.), Leiden University Medical Center; Departments of Radiology (I.C.v.d.S., B.K.V.) and Neurology (L.J.K.), Department of Neurology and Neurosurgery, Brain Center Rudolf Magnus (A.A.), and Julius Center for Health Sciences and Primary Care (A.A.), University Medical Center Utrecht; and Department of Neurology (J.A.V., W.S.), St Antonius Hospital, Nieuwegein, Netherlands
| | - Irene C van der Schaaf
- From the Department of Neurology (H.J.A.v.O., I.A.M., G.M.T., M.D.F., M.J.H.W.) and Department of Radiology (M.A.A.v.W.), Division of Image Processing (A.B.), Leiden University Medical Center; Departments of Radiology (I.C.v.d.S., B.K.V.) and Neurology (L.J.K.), Department of Neurology and Neurosurgery, Brain Center Rudolf Magnus (A.A.), and Julius Center for Health Sciences and Primary Care (A.A.), University Medical Center Utrecht; and Department of Neurology (J.A.V., W.S.), St Antonius Hospital, Nieuwegein, Netherlands
| | - L Jaap Kappelle
- From the Department of Neurology (H.J.A.v.O., I.A.M., G.M.T., M.D.F., M.J.H.W.) and Department of Radiology (M.A.A.v.W.), Division of Image Processing (A.B.), Leiden University Medical Center; Departments of Radiology (I.C.v.d.S., B.K.V.) and Neurology (L.J.K.), Department of Neurology and Neurosurgery, Brain Center Rudolf Magnus (A.A.), and Julius Center for Health Sciences and Primary Care (A.A.), University Medical Center Utrecht; and Department of Neurology (J.A.V., W.S.), St Antonius Hospital, Nieuwegein, Netherlands
| | - Birgitta K Velthuis
- From the Department of Neurology (H.J.A.v.O., I.A.M., G.M.T., M.D.F., M.J.H.W.) and Department of Radiology (M.A.A.v.W.), Division of Image Processing (A.B.), Leiden University Medical Center; Departments of Radiology (I.C.v.d.S., B.K.V.) and Neurology (L.J.K.), Department of Neurology and Neurosurgery, Brain Center Rudolf Magnus (A.A.), and Julius Center for Health Sciences and Primary Care (A.A.), University Medical Center Utrecht; and Department of Neurology (J.A.V., W.S.), St Antonius Hospital, Nieuwegein, Netherlands
| | - Alexander Broersen
- From the Department of Neurology (H.J.A.v.O., I.A.M., G.M.T., M.D.F., M.J.H.W.) and Department of Radiology (M.A.A.v.W.), Division of Image Processing (A.B.), Leiden University Medical Center; Departments of Radiology (I.C.v.d.S., B.K.V.) and Neurology (L.J.K.), Department of Neurology and Neurosurgery, Brain Center Rudolf Magnus (A.A.), and Julius Center for Health Sciences and Primary Care (A.A.), University Medical Center Utrecht; and Department of Neurology (J.A.V., W.S.), St Antonius Hospital, Nieuwegein, Netherlands
| | - Jan A Vos
- From the Department of Neurology (H.J.A.v.O., I.A.M., G.M.T., M.D.F., M.J.H.W.) and Department of Radiology (M.A.A.v.W.), Division of Image Processing (A.B.), Leiden University Medical Center; Departments of Radiology (I.C.v.d.S., B.K.V.) and Neurology (L.J.K.), Department of Neurology and Neurosurgery, Brain Center Rudolf Magnus (A.A.), and Julius Center for Health Sciences and Primary Care (A.A.), University Medical Center Utrecht; and Department of Neurology (J.A.V., W.S.), St Antonius Hospital, Nieuwegein, Netherlands
| | - Gisela M Terwindt
- From the Department of Neurology (H.J.A.v.O., I.A.M., G.M.T., M.D.F., M.J.H.W.) and Department of Radiology (M.A.A.v.W.), Division of Image Processing (A.B.), Leiden University Medical Center; Departments of Radiology (I.C.v.d.S., B.K.V.) and Neurology (L.J.K.), Department of Neurology and Neurosurgery, Brain Center Rudolf Magnus (A.A.), and Julius Center for Health Sciences and Primary Care (A.A.), University Medical Center Utrecht; and Department of Neurology (J.A.V., W.S.), St Antonius Hospital, Nieuwegein, Netherlands
| | - Wouter Schonewille
- From the Department of Neurology (H.J.A.v.O., I.A.M., G.M.T., M.D.F., M.J.H.W.) and Department of Radiology (M.A.A.v.W.), Division of Image Processing (A.B.), Leiden University Medical Center; Departments of Radiology (I.C.v.d.S., B.K.V.) and Neurology (L.J.K.), Department of Neurology and Neurosurgery, Brain Center Rudolf Magnus (A.A.), and Julius Center for Health Sciences and Primary Care (A.A.), University Medical Center Utrecht; and Department of Neurology (J.A.V., W.S.), St Antonius Hospital, Nieuwegein, Netherlands
| | - Michel D Ferrari
- From the Department of Neurology (H.J.A.v.O., I.A.M., G.M.T., M.D.F., M.J.H.W.) and Department of Radiology (M.A.A.v.W.), Division of Image Processing (A.B.), Leiden University Medical Center; Departments of Radiology (I.C.v.d.S., B.K.V.) and Neurology (L.J.K.), Department of Neurology and Neurosurgery, Brain Center Rudolf Magnus (A.A.), and Julius Center for Health Sciences and Primary Care (A.A.), University Medical Center Utrecht; and Department of Neurology (J.A.V., W.S.), St Antonius Hospital, Nieuwegein, Netherlands
| | - Ale Algra
- From the Department of Neurology (H.J.A.v.O., I.A.M., G.M.T., M.D.F., M.J.H.W.) and Department of Radiology (M.A.A.v.W.), Division of Image Processing (A.B.), Leiden University Medical Center; Departments of Radiology (I.C.v.d.S., B.K.V.) and Neurology (L.J.K.), Department of Neurology and Neurosurgery, Brain Center Rudolf Magnus (A.A.), and Julius Center for Health Sciences and Primary Care (A.A.), University Medical Center Utrecht; and Department of Neurology (J.A.V., W.S.), St Antonius Hospital, Nieuwegein, Netherlands
| | - Marianne A A van Walderveen
- From the Department of Neurology (H.J.A.v.O., I.A.M., G.M.T., M.D.F., M.J.H.W.) and Department of Radiology (M.A.A.v.W.), Division of Image Processing (A.B.), Leiden University Medical Center; Departments of Radiology (I.C.v.d.S., B.K.V.) and Neurology (L.J.K.), Department of Neurology and Neurosurgery, Brain Center Rudolf Magnus (A.A.), and Julius Center for Health Sciences and Primary Care (A.A.), University Medical Center Utrecht; and Department of Neurology (J.A.V., W.S.), St Antonius Hospital, Nieuwegein, Netherlands
| | - Marieke J H Wermer
- From the Department of Neurology (H.J.A.v.O., I.A.M., G.M.T., M.D.F., M.J.H.W.) and Department of Radiology (M.A.A.v.W.), Division of Image Processing (A.B.), Leiden University Medical Center; Departments of Radiology (I.C.v.d.S., B.K.V.) and Neurology (L.J.K.), Department of Neurology and Neurosurgery, Brain Center Rudolf Magnus (A.A.), and Julius Center for Health Sciences and Primary Care (A.A.), University Medical Center Utrecht; and Department of Neurology (J.A.V., W.S.), St Antonius Hospital, Nieuwegein, Netherlands
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