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Lu X, Luo Y, Fawaz M, Zhu C, Chai C, Wu G, Wang H, Liu J, Zou Y, Gong Y, Haacke EM, Xia S. Dynamic Changes of Asymmetric Cortical Veins Relate to Neurologic Prognosis in Acute Ischemic Stroke. Radiology 2021; 301:672-681. [PMID: 34581624 DOI: 10.1148/radiol.2021210201] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Background Cerebral oxygenation is closely related to neural function in acute ischemic stroke (AIS) and can be measured noninvasively from asymmetrically prominent cortical veins (APCVs) using quantitative susceptibility mapping (QSM). Purpose To quantify venous oxygen saturation (SvO2) using brain MRI with QSM in patients with AIS, to analyze its change at 2-week follow-up, and to assess the influence of SvO2 in clinical prognosis. Materials and Methods Between 2016 and 2020, consecutive patients with AIS who underwent brain MRI within 24 hours from symptom onset and 2 weeks after treatment were retrospectively enrolled. The SvO2 of APCVs was quantified using QSM. The independent sample t test was used to compare the SvO2 between patients with and patients without APCVs. The paired sample t test was used to assess the dynamic change in SvO2. Pearson and Spearman correlation analysis was used to explore the relationship among dynamic change in SvO2 and hypoperfusion, National Institutes of Health Stroke Scale (NIHSS) score change, and 90-day modified Rankin Scale (mRS) score. The independent sample t test was used to compare the dynamic change in SvO2 between different clinical prognoses and outcome subgroups. Results APCVs were detected in 39 of 73 patients (mean age, 70 years ± 10 [standard deviation]; 49 men) at admission and disappeared in 35 patients at 2-week follow-up MRI. The mean SvO2 increased from 35.0% ± 5.8 to 64.5% ± 10.0 (P < .001) in 39 patients. For the 35 patients with APCVs that disappeared, the dynamic change in SvO2 negatively correlated with change in NIHSS score (r = -0.37, R2 = 0.19, P = .03) and 90-day mRS score (r = -0.54, R2 = 0.27, P = .001), and the dynamic change in SvO2 in the subgroup with good 90-day outcomes (n = 19) was greater than that in the subgroup with poor 90-day outcomes (n = 16) (mean, 34.5% ± 5.8 vs 29.7% ± 6.3; 95% CI: 0.6, 8.9; P = .03). Conclusion Improved oxygen saturation of asymmetric cortical veins detected using brain MRI with quantitative susceptibility mapping corresponded with better acute ischemic stroke outcomes for patients with asymmetrically prominent cortical veins that disappeared at 2-week follow-up MRI. © RSNA, 2021 Online supplemental material is available for this article.
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Affiliation(s)
- Xiudi Lu
- From the Department of Radiology, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, China (X.L., J.L., Y.Z.); Department of Radiology, Translational Research Institute of Brain and Brain-Like Intelligence, Shanghai Fourth People's Hospital Affiliated to Tongji University School of Medicine, Shanghai, China (Y.L.); Department of Radiology, Wayne State University, Detroit, Mich (M.F., E.M.H.); Department of Radiology, University of Washington, Seattle, Wash (C.Z.); Department of Radiology, Tianjin First Central Hospital, School of Medicine, Nankai University, No. 24 Fukang Road, Nankai District, Tianjin 300192, China (C.C., S.X.); School of Medicine, Nankai University, Tianjin, China (G.W., H.W.); and Department of Radiology, Tianjin Medical University Nankai Hospital, Tianjin, China (Y.G.)
| | - Yu Luo
- From the Department of Radiology, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, China (X.L., J.L., Y.Z.); Department of Radiology, Translational Research Institute of Brain and Brain-Like Intelligence, Shanghai Fourth People's Hospital Affiliated to Tongji University School of Medicine, Shanghai, China (Y.L.); Department of Radiology, Wayne State University, Detroit, Mich (M.F., E.M.H.); Department of Radiology, University of Washington, Seattle, Wash (C.Z.); Department of Radiology, Tianjin First Central Hospital, School of Medicine, Nankai University, No. 24 Fukang Road, Nankai District, Tianjin 300192, China (C.C., S.X.); School of Medicine, Nankai University, Tianjin, China (G.W., H.W.); and Department of Radiology, Tianjin Medical University Nankai Hospital, Tianjin, China (Y.G.)
| | - Miller Fawaz
- From the Department of Radiology, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, China (X.L., J.L., Y.Z.); Department of Radiology, Translational Research Institute of Brain and Brain-Like Intelligence, Shanghai Fourth People's Hospital Affiliated to Tongji University School of Medicine, Shanghai, China (Y.L.); Department of Radiology, Wayne State University, Detroit, Mich (M.F., E.M.H.); Department of Radiology, University of Washington, Seattle, Wash (C.Z.); Department of Radiology, Tianjin First Central Hospital, School of Medicine, Nankai University, No. 24 Fukang Road, Nankai District, Tianjin 300192, China (C.C., S.X.); School of Medicine, Nankai University, Tianjin, China (G.W., H.W.); and Department of Radiology, Tianjin Medical University Nankai Hospital, Tianjin, China (Y.G.)
| | - Chengcheng Zhu
- From the Department of Radiology, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, China (X.L., J.L., Y.Z.); Department of Radiology, Translational Research Institute of Brain and Brain-Like Intelligence, Shanghai Fourth People's Hospital Affiliated to Tongji University School of Medicine, Shanghai, China (Y.L.); Department of Radiology, Wayne State University, Detroit, Mich (M.F., E.M.H.); Department of Radiology, University of Washington, Seattle, Wash (C.Z.); Department of Radiology, Tianjin First Central Hospital, School of Medicine, Nankai University, No. 24 Fukang Road, Nankai District, Tianjin 300192, China (C.C., S.X.); School of Medicine, Nankai University, Tianjin, China (G.W., H.W.); and Department of Radiology, Tianjin Medical University Nankai Hospital, Tianjin, China (Y.G.)
| | - Chao Chai
- From the Department of Radiology, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, China (X.L., J.L., Y.Z.); Department of Radiology, Translational Research Institute of Brain and Brain-Like Intelligence, Shanghai Fourth People's Hospital Affiliated to Tongji University School of Medicine, Shanghai, China (Y.L.); Department of Radiology, Wayne State University, Detroit, Mich (M.F., E.M.H.); Department of Radiology, University of Washington, Seattle, Wash (C.Z.); Department of Radiology, Tianjin First Central Hospital, School of Medicine, Nankai University, No. 24 Fukang Road, Nankai District, Tianjin 300192, China (C.C., S.X.); School of Medicine, Nankai University, Tianjin, China (G.W., H.W.); and Department of Radiology, Tianjin Medical University Nankai Hospital, Tianjin, China (Y.G.)
| | - Gemuer Wu
- From the Department of Radiology, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, China (X.L., J.L., Y.Z.); Department of Radiology, Translational Research Institute of Brain and Brain-Like Intelligence, Shanghai Fourth People's Hospital Affiliated to Tongji University School of Medicine, Shanghai, China (Y.L.); Department of Radiology, Wayne State University, Detroit, Mich (M.F., E.M.H.); Department of Radiology, University of Washington, Seattle, Wash (C.Z.); Department of Radiology, Tianjin First Central Hospital, School of Medicine, Nankai University, No. 24 Fukang Road, Nankai District, Tianjin 300192, China (C.C., S.X.); School of Medicine, Nankai University, Tianjin, China (G.W., H.W.); and Department of Radiology, Tianjin Medical University Nankai Hospital, Tianjin, China (Y.G.)
| | - Huiying Wang
- From the Department of Radiology, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, China (X.L., J.L., Y.Z.); Department of Radiology, Translational Research Institute of Brain and Brain-Like Intelligence, Shanghai Fourth People's Hospital Affiliated to Tongji University School of Medicine, Shanghai, China (Y.L.); Department of Radiology, Wayne State University, Detroit, Mich (M.F., E.M.H.); Department of Radiology, University of Washington, Seattle, Wash (C.Z.); Department of Radiology, Tianjin First Central Hospital, School of Medicine, Nankai University, No. 24 Fukang Road, Nankai District, Tianjin 300192, China (C.C., S.X.); School of Medicine, Nankai University, Tianjin, China (G.W., H.W.); and Department of Radiology, Tianjin Medical University Nankai Hospital, Tianjin, China (Y.G.)
| | - Jihua Liu
- From the Department of Radiology, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, China (X.L., J.L., Y.Z.); Department of Radiology, Translational Research Institute of Brain and Brain-Like Intelligence, Shanghai Fourth People's Hospital Affiliated to Tongji University School of Medicine, Shanghai, China (Y.L.); Department of Radiology, Wayne State University, Detroit, Mich (M.F., E.M.H.); Department of Radiology, University of Washington, Seattle, Wash (C.Z.); Department of Radiology, Tianjin First Central Hospital, School of Medicine, Nankai University, No. 24 Fukang Road, Nankai District, Tianjin 300192, China (C.C., S.X.); School of Medicine, Nankai University, Tianjin, China (G.W., H.W.); and Department of Radiology, Tianjin Medical University Nankai Hospital, Tianjin, China (Y.G.)
| | - Ying Zou
- From the Department of Radiology, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, China (X.L., J.L., Y.Z.); Department of Radiology, Translational Research Institute of Brain and Brain-Like Intelligence, Shanghai Fourth People's Hospital Affiliated to Tongji University School of Medicine, Shanghai, China (Y.L.); Department of Radiology, Wayne State University, Detroit, Mich (M.F., E.M.H.); Department of Radiology, University of Washington, Seattle, Wash (C.Z.); Department of Radiology, Tianjin First Central Hospital, School of Medicine, Nankai University, No. 24 Fukang Road, Nankai District, Tianjin 300192, China (C.C., S.X.); School of Medicine, Nankai University, Tianjin, China (G.W., H.W.); and Department of Radiology, Tianjin Medical University Nankai Hospital, Tianjin, China (Y.G.)
| | - Yan Gong
- From the Department of Radiology, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, China (X.L., J.L., Y.Z.); Department of Radiology, Translational Research Institute of Brain and Brain-Like Intelligence, Shanghai Fourth People's Hospital Affiliated to Tongji University School of Medicine, Shanghai, China (Y.L.); Department of Radiology, Wayne State University, Detroit, Mich (M.F., E.M.H.); Department of Radiology, University of Washington, Seattle, Wash (C.Z.); Department of Radiology, Tianjin First Central Hospital, School of Medicine, Nankai University, No. 24 Fukang Road, Nankai District, Tianjin 300192, China (C.C., S.X.); School of Medicine, Nankai University, Tianjin, China (G.W., H.W.); and Department of Radiology, Tianjin Medical University Nankai Hospital, Tianjin, China (Y.G.)
| | - E Mark Haacke
- From the Department of Radiology, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, China (X.L., J.L., Y.Z.); Department of Radiology, Translational Research Institute of Brain and Brain-Like Intelligence, Shanghai Fourth People's Hospital Affiliated to Tongji University School of Medicine, Shanghai, China (Y.L.); Department of Radiology, Wayne State University, Detroit, Mich (M.F., E.M.H.); Department of Radiology, University of Washington, Seattle, Wash (C.Z.); Department of Radiology, Tianjin First Central Hospital, School of Medicine, Nankai University, No. 24 Fukang Road, Nankai District, Tianjin 300192, China (C.C., S.X.); School of Medicine, Nankai University, Tianjin, China (G.W., H.W.); and Department of Radiology, Tianjin Medical University Nankai Hospital, Tianjin, China (Y.G.)
| | - Shuang Xia
- From the Department of Radiology, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, China (X.L., J.L., Y.Z.); Department of Radiology, Translational Research Institute of Brain and Brain-Like Intelligence, Shanghai Fourth People's Hospital Affiliated to Tongji University School of Medicine, Shanghai, China (Y.L.); Department of Radiology, Wayne State University, Detroit, Mich (M.F., E.M.H.); Department of Radiology, University of Washington, Seattle, Wash (C.Z.); Department of Radiology, Tianjin First Central Hospital, School of Medicine, Nankai University, No. 24 Fukang Road, Nankai District, Tianjin 300192, China (C.C., S.X.); School of Medicine, Nankai University, Tianjin, China (G.W., H.W.); and Department of Radiology, Tianjin Medical University Nankai Hospital, Tianjin, China (Y.G.)
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Yin Y, Shu S, Qin L, Shan Y, Gao JH, Lu J. Effects of mild hypoxia on oxygen extraction fraction responses to brain stimulation. J Cereb Blood Flow Metab 2021; 41:2216-2228. [PMID: 33563081 PMCID: PMC8393298 DOI: 10.1177/0271678x21992896] [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] [Indexed: 11/16/2022]
Abstract
Characterizing the effect of limited oxygen availability on brain metabolism during brain activation is an essential step towards a better understanding of brain homeostasis and has obvious clinical implications. However, how the cerebral oxygen extraction fraction (OEF) depends on oxygen availability during brain activation remains unclear, which is mostly attributable to the scarcity and safety of measurement techniques. Recently, a magnetic resonance imaging (MRI) method that enables noninvasive and dynamic measurement of the OEF has been developed and confirmed to be applicable to functional MRI studies. Using this novel method, the present study investigated the motor-evoked OEF response in both normoxia (21% O2) and hypoxia (12% O2). Our results showed that OEF activation decreased in the brain areas involved in motor task execution. Decreases in the motor-evoked OEF response were greater under hypoxia (-21.7% ± 5.5%) than under normoxia (-11.8% ± 3.7%) and showed a substantial decrease as a function of arterial oxygen saturation. These findings suggest a different relationship between oxygen delivery and consumption during hypoxia compared to normoxia. This methodology may provide a new perspective on the effects of mild hypoxia on brain function.
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Affiliation(s)
- Yayan Yin
- Department of Radiology, Xuanwu Hospital, Capital Medical University, Beijing, China.,Beijing Key Laboratory of Magnetic Resonance Imaging and Brain Informatics, Beijing, China
| | - Su Shu
- Beijing City Key Lab for Medical Physics and Engineering, Institute of Heavy Ion Physics, School of Physics, Peking University, Beijing, China.,Center for MRI Research, Academy for Advanced Interdisciplinary Studies, Peking University, Beijing, China
| | - Lang Qin
- Beijing City Key Lab for Medical Physics and Engineering, Institute of Heavy Ion Physics, School of Physics, Peking University, Beijing, China.,Center for MRI Research, Academy for Advanced Interdisciplinary Studies, Peking University, Beijing, China
| | - Yi Shan
- Department of Radiology, Xuanwu Hospital, Capital Medical University, Beijing, China.,Beijing Key Laboratory of Magnetic Resonance Imaging and Brain Informatics, Beijing, China
| | - Jia-Hong Gao
- Beijing City Key Lab for Medical Physics and Engineering, Institute of Heavy Ion Physics, School of Physics, Peking University, Beijing, China.,Center for MRI Research, Academy for Advanced Interdisciplinary Studies, Peking University, Beijing, China.,McGovern Institution for Brain Research, Peking University, Beijing, China
| | - Jie Lu
- Department of Radiology, Xuanwu Hospital, Capital Medical University, Beijing, China.,Beijing Key Laboratory of Magnetic Resonance Imaging and Brain Informatics, Beijing, China.,Department of Nuclear Medicine, Xuanwu Hospital, Capital Medical University, Beijing, China
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