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Detection of preclinically latent hyperperfusion due to stroke-like episodes by arterial spin-labeling perfusion MRI

Masamichi Ikawa1, Makoto Yoneda, Tomoko Muramatsu

  • 1Second Department of Internal Medicine, Faculty of Medical Sciences, University of Fukui, 23-3 Shimoaiduki, Matsuoka, Eiheiji-cho, Fukui 910-1193, Japan.

Mitochondrion
|October 8, 2013
PubMed

Insights

Arterial spin labeling (ASL) MRI detected preclinical cerebral hyperperfusion in Mitochondrial Myopathy, Encephalopathy, Lactic Acidosis, and Stroke-like episodes (MELAS) patients. This finding may help predict impending stroke-like episodes (SEs) months before they occur.

Area of Science:

  • Neurology
  • Radiology
  • Mitochondrial Diseases

Background:

  • Detecting preclinical lesions in MELAS patients is challenging.
  • Stroke-like episodes (SEs) are a significant complication of MELAS.

Purpose of the Study:

  • To investigate the utility of arterial spin labeling (ASL) perfusion MRI in identifying preclinical lesions in MELAS patients.
  • To assess ASL's potential for predicting the onset of SEs.

Main Methods:

  • Utilized ASL perfusion magnetic resonance imaging (MRI) in three MELAS patients.
  • Compared ASL findings with conventional MRI in the preclinical phase of SEs.

Main Results:

  • Regional cerebral hyperperfusion was observed on ASL MRI more than 3 months before clinical SE onset in all three patients.
  • These hyperperfused areas were not detectable by conventional MRI during the preclinical phase.
  • The preclinical hyperperfused areas evolved into acute lesions at the clinical onset of SEs.

Conclusions:

  • ASL perfusion MRI can detect preclinical cerebral hyperperfusion in MELAS patients.
  • ASL imaging shows potential for predicting the emergence of SEs in MELAS.
  • Early detection of preclinical lesions may enable timely intervention for MELAS patients.
Keywords:
(123)I-IMPA-to-G transition at nucleotide position 3243A3243GASLArterial spin labelingCBFDWIsFLAIRMELASMRAMRIMRSN-isopropyl-p-[(123)I]iodoamphetaminePETPerfusion imagingSEsSPECTStroke-like episodesarterial spin labelingcerebral blood flowdiffusion-weighted imagesfluid-attenuated inversion recoverymagnetic resonance angiographymagnetic resonance imagingmagnetic resonance spectroscopymitochondrial DNAmitochondrial myopathy, encephalopathy, lactic acidosis and stroke-like episodesmtDNApositron emission tomographyrCBFregional cerebral blood flowsingle-photon emission computed tomographystroke-like episodes

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