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(Stroke. 2003;34:1662.)
© 2003 American Heart Association, Inc.

Original Contributions

Cerebral Hemodynamic Evaluation Using Perfusion-Weighted Magnetic Resonance Imaging

Comparison With Positron Emission Tomography Values in Chronic Occlusive Carotid Disease

Katsufumi Kajimoto, MD; Hiroshi Moriwaki, MD; Naoaki Yamada, MD; Kohei Hayashida, MD; Junya Kobayashi, MD; Kotaro Miyashita, MD Hiroaki Naritomi, MD

From the Departments of Cerebrovascular Medicine (K.K., H.M., J.K., K.M., H.N.) and Radiology and Nuclear Medicine (N.Y., K.H.), National Cardiovascular Center, Osaka, Japan.

Reprint requests to Katsufumi Kajimoto, MD, Department of Cerebrovascular Medicine, National Cardiovascular Center, 5-7-1 Fujishirodai, Suita City, Osaka 565-8565, Japan. E-mail kkajimot{at}hsp.ncvc.go.jp

Background and Purpose— Perfusion-weighted magnetic resonance imaging (PWI) is a reliable and semiquantitative method for estimating cerebral hemodynamics. We sought to evaluate the potential of PWI for assessing cerebral blood flow (CBF) and metabolism compared with positron emission tomography (PET) in patients with chronic occlusive carotid disease.

Methods— In 24 patients with chronic unilateral occlusive carotid disease, time-to-peak (TTP) delay (TTP-D) measured by PWI was compared with CBF, cerebral blood volume (CBV), and oxygen extraction fraction (OEF) obtained by PET. TTP indicates the time from the start of PWI to the bolus peak. TTP-D indicates the difference in TTP values between the occlusive and contralateral hemispheres. TTP-D was compared between patients with normal and reduced CBF/CBV and also between patients with normal and elevated OEF.

Results— TTP-D in patients with reduced CBF/CBV was significantly longer than that in patients with normal CBF/CBV (3.4±1.8 versus 1.4±0.7 seconds; P<0.001). In the patients with reduced CBF/CBV, TTP-D correlated with OEF significantly (r=0.710, P<0.0001). TTP-D in patients with elevated OEF was significantly longer than that in patients with normal OEF (4.8±2.2 versus 2.0±0.9 seconds; P<0.01). In all 5 patients with TTP-D 4 seconds, OEF was elevated markedly.

Conclusions— TTP-D 4 seconds is considered to indicate a high risk of hemodynamic failure. The measurement of TTP-D by PWI appears to provide important clinical information for evaluating cerebral hemodynamics in chronic occlusive carotid disease.

Key Words: carotid artery occlusion • hemodynamics • magnetic resonance imaging, perfusion-weighted • tomography, emission computed

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