Spatial integration of multimodal brain images in cerebral infarction

Different structural as well as functional imaging techniques are becoming increasingly important in the investigation of patients suffering from an ischemic stroke. Available imaging procedures usually provide complementary data, but the images can not easily be compared due to differences in patient positioning, angulation, and slice thickness. We studied the value of spatial integration of images from different modalities in a patient with an ischemic stroke and used skin markers to integrate the obtained information. Computed tomography (CT), magnetic resonance imaging (MRI), 99mTcHMPAO-single photon emission computed tomography (SPECT) and magnetic resonance spectroscopic imaging (MRSI) were performed in a patient, presenting with a right sided hemiparesis caused by an ischemic stroke. Combination of MRI with CT demonstrated that the infarction visible on CT and MRI corresponded in size and volume. Furthermore, structural and functional images could readily be integrated, thus allowing us to obtain accurate information in this stroke patient. Different imaging modalities provide complementary information in the acute phase of cerebral infarction and multimodality matching can be of great value for improvement of our understanding of the pathophysiology and course of ischemic stroke.