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(Stroke. 2009;40:3012.)
© 2009 American Heart Association, Inc.

Original Contributions

Brain Temperature Measured Using Proton MR Spectroscopy Detects Cerebral Hemodynamic Impairment in Patients With Unilateral Chronic Major Cerebral Artery Steno-Occlusive Disease

Comparison With Positron Emission Tomography

Daiya Ishigaki, MD; Kuniaki Ogasawara, MD; Yoshichika Yoshioka, PhD; Kohei Chida, MD; Makoto Sasaki, MD; Shunrou Fujiwara, PhD; Kenta Aso, MD; Masakazu Kobayashi, MD; Kenji Yoshida, MD; Kazunori Terasaki, PhD; Takashi Inoue, MD Akira Ogawa, MD

From the Advanced Research Center (D.I., M.S., S.F.), Cyclotron Research Center (K.T.) and the Department of Neurosurgery (K.O., K.C., K.A., M.K., K.Y., T.I., A.O.), School of Medicine, Iwate Medical University, Morioka, Japan; and Biofunctional Imaging (Y.Y.), Immunology Frontier Research Center, Osaka University, Suita, Japan.

Correspondence to Kuniaki Ogasawara, MD, Department of Neurosurgery, School of Medicine, Iwate Medical University, 19-1 Uchimaru, Morioka, Iwate 020-8505, Japan. E-mail kuogasa{at}iwate-med.ac.jp

Background and Purpose— Brain temperature is determined by the balance between heat produced by cerebral energy turnover and heat removed by cerebral blood flow. The purpose of the present study was to investigate whether brain temperature measured noninvasively using proton MR spectroscopy can detect cerebral hemodynamic impairment in patients with unilateral chronic internal carotid or middle cerebral artery occlusive disease when compared with positron emission tomography.

Methods— Brain temperature, cerebral blood flow, and metabolism were measured using proton MR spectroscopy and ¹⁵O-positron emission tomography, respectively, in 21 normal subjects and 37 patients. Positron emission tomography images were coregistered with MR images and resliced automatically using image analysis software. Regions of interest placed in both cerebral hemispheres on MR images were automatically superimposed in these resliced positron emission tomography images.

Results— A significant correlation was observed between brain temperature difference (affected hemisphere–contralateral hemisphere) and both cerebral blood volume and oxygen extraction fraction ratio (affected hemisphere/contralateral hemisphere; r=0.607; P=0.0004 and r=0.631; P=0.0002). With abnormally elevated cerebral blood volume or oxygen extraction fraction ratio defined as higher than the mean +2 SDs obtained from normal subjects, brain temperature difference provided 86% or 92% sensitivity and 87% or 84% specificity with 80% or 73% positive and 91% or 95% negative predictive values for detecting abnormally elevated cerebral blood volume or oxygen extraction fraction ratios, respectively.

Conclusions— Brain temperature measured using proton MR spectroscopy can detect cerebral hemodynamic impairment in patients with unilateral chronic major cerebral artery steno-occlusive disease.

Key Words: brain temperature • hemodynamic impairment • magnetic resonance spectroscopy • positron emission tomography