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Related Experiment Videos

Assessing tissue viability with MR diffusion and perfusion imaging.

Pamela W Schaefer1, Yelda Ozsunar, Julian He

  • 1Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA.

AJNR. American Journal of Neuroradiology
|March 15, 2003
PubMed
Summary
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Relative cerebral blood flow (rCBF) ratio is key in distinguishing brain tissue likely to infarct from that which will survive hypoperfusion. This MRI parameter aids stroke outcome prediction.

Area of Science:

  • Neurology
  • Radiology
  • Medical Imaging

Background:

  • Diffusion-weighted (DW) and perfusion-weighted (PW) MRI reveal neurophysiological changes during stroke.
  • Identifying brain regions at risk of infarction versus those that will survive hypoperfusion is crucial.

Purpose of the Study:

  • To determine which MR imaging parameters can differentiate brain tissue destined for infarction from viable tissue.
  • To assess the utility of various imaging ratios in predicting stroke outcomes.

Main Methods:

  • DW and PW MRI were acquired in 30 stroke patients (1-12 hours post-symptom onset).
  • Ratios of relative cerebral blood volume (rCBV), flow (rCBF), mean transit time (MTT), apparent diffusion coefficient (ADC), DW signal intensity, and fractional anisotropy (FA) were calculated.

Related Experiment Videos

  • These ratios were analyzed in infarct core, infarcted penumbra, and viable hypoperfused tissue regions.

    • Main Results:

    • Relative cerebral blood flow (rCBF) ratios significantly differed across all three tissue regions.
    • DW image intensity and ADC ratios also showed significant differences but were less distinct than rCBF.
    • Specific thresholds for rCBF, rCBV, ADC, DW intensity, and FA ratios were identified to predict tissue viability.

    Conclusions:

    • The rCBF ratio demonstrated the greatest difference among the investigated tissue regions.
    • rCBF is likely the most valuable parameter for distinguishing between tissue that will infarct and tissue that will survive hypoperfusion.
    • ADC, DW intensity, FA, and rCBV ratios may offer supplementary information for stroke outcome prediction.