This Article Full Text Full Text (PDF) All Versions of this Article: 35/9/2105    most recent 01.STR.0000136950.63209.49v1 Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Pedraza, S. Articles by Dávalos, A. Search for Related Content PubMed PubMed Citation Articles by Pedraza, S. Articles by Dávalos, A. Related Collections Computerized tomography and Magnetic Resonance Imaging

(Stroke. 2004;35:2105.)
© 2004 American Heart Association, Inc.

Original Contributions

Comparison of Preperfusion and Postperfusion Magnetic Resonance Angiography in Acute Stroke

Salvador Pedraza, MD; Yolanda Silva, MD; José Mendez, MD; Luis Inaraja, MD, PhD; Joana Vera, MD; Joaquín Serena, MD, PhD Antoni Dávalos, MD, PhD

From the Service of Radiology (S.P., J.M., L.I., J.V.), Unidad de RM-IDI, and the Department of Neurology (Y.S., J.S., A.D.), Hospital Universitari Doctor Josep Trueta, Girona, Spain. Center affiliated with the Universitat Autònoma de Barcelona.

Correspondence to Dr Salvador Pedraza Gutiérrez, Unidad de RM-IDI, Servicio de Radiología, Hospital Josep Trueta, C/de França s/n, Girona 17007, Spain. E-mail spedraza{at}retemail.es

Background and Purpose— The multimodal magnetic resonance imaging study in acute stroke includes perfusion-weighted imaging (PWI) after administration of contrast and magnetic resonance angiography (MRA). However, MRA may overestimate the degree of vessel obstruction caused by limitations to detect low flow states. Our aim was to determine the usefulness of a new fast imaging protocol combining classical MRA, PWI, and postperfusion MRA to improve the diagnostic management in acute ischemic stroke.

Methods— We studied 31 patients with a middle cerebral artery (MCA) infarction within the first 12 hours from the onset of symptoms. All patients had an MCA stenosis or occlusion. The study protocol included a preperfusion MRA and a postperfusion MRA. Modified thrombolysis in myocardial infarction (TIMI) classification was used to assess the patency of vessels.

Results— In 17 patients (group A, 55%), preperfusion MRA and postperfusion MRA accorded in the estimation of vascular status, whereas in 14 patients (group B, 45%) postperfusion MRA showed a better vascular flow than preperfusion MRA. The improvement in the depiction of flow was from a complete occlusion (TIMI I) to a partial occlusion (TIMI II) in 9 patients and from TIMI II to normal patency (TIMI III) in 5 patients. Thirty-six percent of the patients with suspected internal carotid artery occlusion in the preperfusion MRA showed flow in the intracranial internal carotid artery in the postperfusion MRA.

Conclusions— Postperfusion contrast-enhanced MRA can demonstrate arterial segments with low flow and avoid overestimation of vascular obstruction.

Key Words: angiography • contrast media • magnetic resonance • myocardial infarction

This article has been cited by other articles:

				H. Ishimaru, M. Ochi, M. Morikawa, H. Takahata, Y. Matsuoka, T. Koshiishi, T. Fujimoto, A. Egawa, K. Mitarai, T. Murakami, et al. Accuracy of Pre- and Postcontrast 3D Time-of-Flight MR Angiography in Patients with Acute Ischemic Stroke: Correlation with Catheter Angiography AJNR Am. J. Neuroradiol., May 1, 2007; 28(5): 923 - 926. [Abstract] [Full Text] [PDF]

				S. Pedraza, Y. Silva, S. Remollo, J. Puig, A. Quiles, E. Gomez, M. Castellanos, J. Serena, and A. Davalos Response to Letter by Sohn et al Stroke, April 1, 2007; 38(4): 1134 - 1134. [Full Text] [PDF]

				C.-H. Sohn, S.-I. Sohn, H.-W. Chang, and A. M. Demchuk Postcontrast Time-of-Flight MR Angiography Demonstrating Collateral Flow in Acute Stroke Stroke, April 1, 2007; 38(4): 1132 - 1132. [Full Text] [PDF]

				T. Tomsick TIMI, TIBI, TICI: I Came, I Saw, I Got Confused AJNR Am. J. Neuroradiol., February 1, 2007; 28(2): 382 - 384. [Full Text] [PDF]