Stroke, Vol 25, 494-500, Copyright © 1994 by American Heart Association
T Back, M Hoehn-Berlage, K Kohno and KA Hossmann
BACKGROUND AND PURPOSE: Diffusion-weighted nuclear magnetic resonance
imaging has been shown to detect early ischemia-related alterations in
experimental stroke. This raises the question of whether the observed
increase in signal intensity is correlated with changes in cerebral
metabolism. After middle cerebral artery occlusion, nuclear magnetic
resonance diffusion images were recorded and compared with the regional
concentration of cerebral metabolites and with histology of identical
planes. METHODS: Seven anesthetized Fischer rats were subjected to
permanent occlusion of the middle cerebral artery. T1, T2, and diffusion
images (b factors ranging from 0 to 1500 s/mm2) were measured in three to
five planes after 7 hours. Thereafter, brains were frozen in situ for
histology and quantitative bioluminescence imaging of ATP, glucose,
lactate, and for fluorescence imaging of tissue pH. RESULTS: Seven hours
after middle cerebral artery occlusion, the apparent diffusion coefficient
was reduced from 615 +/- 97 x 10(-6).mm2.s-1 (contralateral brain) to 359
+/- 42 x 10(-6).mm2.s-1 (ischemic brain; mean +/- SD, P < .01). A
precise topical coincidence was demonstrated between changes in nuclear
magnetic resonance diffusion images, pattern of histological damage,
ATP-depleted areas, and local tissue acidosis, the lesion area amounting to
between 24.1% and 27.6% of the hemisphere at the level of the
caudate-putamen. The area of elevated brain lactate clearly exceeded the
acidic core of the infarct and included the slightly alkaline border zone.
CONCLUSIONS: The data demonstrate that after 7-hour middle cerebral artery
occlusion, the reduction of the apparent diffusion coefficient in nuclear
magnetic resonance diffusion images reflects precisely the region of
histological injury, breakdown of energy metabolism, and tissue acidosis.
ARTICLES
Diffusion nuclear magnetic resonance imaging in experimental stroke. Correlation with cerebral metabolites
Max-Planck-Institute for Neurological Research, Department of Experimental Neurology, Cologne, Germany.
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