Stroke, Vol 19, 28-37, Copyright © 1988 by American Heart Association
B Bose, SC Jones, R Lorig, HT Friel, M Weinstein and JR Little
The spatial correlation of nuclear magnetic resonance imaging (NMRI) and
cerebral blood flow (CBF) may improve our ability to identify ischemic
brain lesions and may provide further insight into the pathophysiology of
early cerebral ischemia. Eleven pentobarbital- anesthetized adult cats
underwent exposure of the common carotid arteries bilaterally and the right
middle cerebral artery through a transorbital approach. Baseline NMRI
images were obtained with a single spin-echo, multislice technique using a
0.6-T field, 0.4-cm slice thickness, and a surface coil. Focal ischemia was
produced with right middle cerebral artery occlusion and potentiated with
bilateral common carotid artery ligation. Sequential NMRI studies were then
performed at 1, 2, 4, 6, and 12 hours or until CBF was determined in the
same cats using [14C]iodoantipyrine at either 2 (n = 2), 4 (n = 2), 6 (n =
2), or 12 (n = 1) hours after the time of occlusion. This protocol allowed
temporal and spatial correlation of NMRI and CBF. Alternate 5-mm brain
slices were incubated with 1% 2,3,5-triphenyltetrazolium chloride (TTC) for
45 minutes at 37-41 degrees C and frozen in liquid Freon for later
autoradiographic CBF determination. Four cats were studied only with NMRI
and TTC (not CBF). The correlation between areas of increased NMRI signal
intensity observed in T2-weighted images (repetition time 2,000 msec, echo
time 120 msec), vital staining with TTC, low CBF, and routine histology was
evaluated. During the early phase (less than 6 hours), T2-weighted NMRI
changes were localized to the central ischemic gray matter areas, as
defined in the later CBF images, with no involvement of the white matter.
By the twelfth hour the NMRI changes involved the entire ischemic area
including gray and white matter. The initial visible changes seen on
T2-weighted NMRI are suggestive of cellular edema, and the later changes
are characteristic of vasogenic edema. The spread of NMRI changes compared
with the ischemic area determined from autoradiographic CBF is consistent
with the previously described biphasic evolution of ischemic injury. These
data suggest that T2-weighted NMRI could be used clinically to delineate
areas of acute ischemic stroke.
ARTICLES
Evolving focal cerebral ischemia in cats: spatial correlation of nuclear magnetic resonance imaging, cerebral blood flow, tetrazolium staining, and histopathology
Department of Neurological Surgery, Cleveland Clinic Foundation, OH 44106-4775.
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