Stroke, Vol 23, 1602-1612, Copyright © 1992 by American Heart Association
AL Busza, KL Allen, MD King, N van Bruggen, SR Williams and DG Gadian
BACKGROUND AND PURPOSE: Diffusion-weighted magnetic resonance imaging has
been shown to be particularly suited to the study of the acute phase of
cerebral ischemia in animal models. The studies reported in this paper were
undertaken to determine whether this technique is sensitive to the known
ischemic thresholds for cerebral tissue energy failure and disturbance of
membrane ion gradients. METHODS: Diffusion- weighted images of the gerbil
brain were acquired under two sets of experimental conditions: as a
function of cerebral blood flow after controlled graded occlusion of the
common carotid arteries (partial ischemia), as a function of time following
complete bilateral carotid artery occlusion (severe global ischemia), and
on deocclusion after 60 minutes of ischemia. RESULTS: During partial
cerebral ischemia, the diffusion-weighted images remained unchanged until
the cerebral blood flow was reduced to 15-20 ml.100 g-1.min-1 and below,
when image intensity increased as the cerebral blood flow was lowered
further. This is similar to the critical flow threshold for maintenance of
tissue high-energy metabolites and ion homeostasis. After the onset of
severe global cerebral ischemia, diffusion-weighted image intensity
increased gradually after a delay of approximately 2.5 minutes, consistent
with complete loss of tissue adenosine triphosphate and with the time
course of increase in extracellular potassium. This hyperintensity
decreased on deocclusion following 60 minutes of ischemia. CONCLUSIONS: The
data suggest that diffusion-weighted imaging is sensitive to the disruption
of tissue energy metabolism or a consequence of this disruption. This
raises the possibility of imaging energy failure noninvasively. In humans,
this could have potential in visualizing brain regions where energy
metabolism is impaired, particularly during the acute phase following
stroke.
ARTICLES
Diffusion-weighted imaging studies of cerebral ischemia in gerbils. Potential relevance to energy failure
Department of Biophysics, Hunterian Institute, Royal College of Surgeons of England, London, UK.
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