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(Stroke. 1996;27:1088-1093.)
© 1996 American Heart Association, Inc.
Articles |
Assessment of Regional Cerebral Blood Volume in Acute Human Stroke by Use of Single-Slice Dynamic Susceptibility Contrast-Enhanced Magnetic Resonance Imaging
From the Departments of Neurology (J.R., W.N., A.S., M.H.) and Radiology (F.G.), Klinikum Mannheim, University of Heidelberg, Germany.
Correspondence to Joachim Röther, MD, Stanford University School of Medicine, Lucas MRS Imaging Center, 1201 Welch Rd, Mail Code 5488, Stanford, CA 94305. E-mail joachim@s-word.stanford.edu.
Background and Purpose The purpose of this study was to evaluate the clinical usefulness of dynamic susceptibility contrast-enhanced MRI (DSC-MRI) in acute cerebral ischemia.
Methods During bolus injection of gadolinium-diethylenetriamine pentaacetic acid, a series of rapid T2*-weighted images was recorded from one slice. Concentration-time curves and images of regional cerebral blood volume (rCBV) were calculated from this data set. DSC-MRI, MR angiography, conventional spin-echo MRI (SE-MRI), and CT were performed in 11 patients within 6 hours after stroke onset and before thrombolytic or anticoagulant treatment was begun. A follow-up MRI examination was performed 24 to 48 hours after stroke onset.
Results In 7 of 11 patients (group 1) with territorial infarcts of the middle (n=6) or posterior cerebral artery (n=1), DSC-MRI showed reduced rCBV in the affected territory before conventional SE-MRI displayed ischemic lesions. DSC-MRI was helpful to differentiate severely ischemic tissue from peri-infarct parenchyma. Partial reperfusion (n=3), unchanged reduction of rCBV (n=2), and progressive reduction of rCBV (n=2) were observed in the follow-up study. Normal DSC-MRI findings were present in 4 of 11 patients (group 2) with lacunar infarcts.
Conclusions DSC-MRI accomplished the detection of the ischemic territory in the very early stage (<6 hours) before SE-MRI delivered unequivocal results. DSC-MRI might be helpful to discriminate completely ischemic tissue from potentially salvageable ischemic parenchyma at risk and may play an important role in stroke therapy and evaluation.
Key Words: cerebral blood volume • plasminogen activator, tissue-type • cerebral ischemia • magnetic resonance imaging
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