Assessment of brain perfusion with MRI: methodology and application to acute stroke
TLDR
It is concluded that MRI is a very powerful way to assess brain perfusion and that its use might help in selecting patients who will benefit most from treatment such as thrombolysis.Abstract:
We review the methodology of brain perfusion measurements with MRI and their application to acute stroke, with particular emphasis on the work awarded by the 6th Lucien Appel Prize for Neuroradiology. The application of the indicator dilution theory to the dynamic susceptibility-weighted bolus-tracking method is explained, as is the approach to obtaining quantitative measurements of cerebral blood flow (CBF) and volume (CBV). Our contribution to methodological developments, such as CBV measurement with the frequency-shifted burst sequence, development of the PRESTO sequence, comparison of different deconvolution methods and of spin- and gradient-echo sequences, and the validation of MRI measurements against positron emission tomography is summarised. The pathophysiology of brain ischaemia and the role of neuroimaging in the setting of acute stroke are reviewed, with an introduction to the concepts of ischaemic penumbra and diffusion/perfusion mismatch. Our work on the determination of absolute CBF and CBV thresholds for predicting the area of infarct growth, identification of the best perfusion parameters (relative or absolute) for predicting the area of infarct growth and the role of MR angiography is also summarised. We conclude that MRI is a very powerful way to assess brain perfusion and that its use might help in selecting patients who will benefit most from treatment such as thrombolysis.read more
Citations
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Journal ArticleDOI
Comparative overview of brain perfusion imaging techniques
Max Wintermark,M. Sesay,Emmanuel L. Barbier,Katalin Borbély,William P. Dillon,James D. Eastwood,Thomas C. Glenn,Cécile Grandin,Salvador Pedraza,Jean F. Soustiel,Tadashi Nariai,Greg Zaharchuk,J.-M. Caille,Vincent Dousset,Howard Yonas +14 more
TL;DR: A comparative overview established by consensus among specialists of the various techniques dedicated to brain hemodynamics is presented, to offer a clearer picture of the pros and cons of currently available brain perfusion imaging techniques.
Journal ArticleDOI
Non-invasive measurement of perfusion: a critical review of arterial spin labelling techniques
TL;DR: The theoretical background and main implementations of ASL are revisited and the perfusion quantification methods, including the problems and pitfalls involved, are thoroughly discussed in this article.
Journal ArticleDOI
Comparative overview of brain perfusion imaging techniques
Max Wintermark,Max Wintermark,M. Sesay,Emmanuel L. Barbier,Katalin Borbély,William P. Dillon,James D. Eastwood,Thomas C. Glenn,Cécile Grandin,Salvador Pedraza,Jean F. Soustiel,Tadashi Nariai,Greg Zaharchuk,J.-M. Caille,Vincent Dousset,Howard Yonas +15 more
TL;DR: For clinicians, this paper should offers a clearer picture of the pros and cons of currently available brain perfusion imaging techniques, and assist them in choosing the proper method in every specific clinical setting.
Journal ArticleDOI
How Reliable Is Perfusion MR in Acute Stroke?: Validation and Determination of the Penumbra Threshold Against Quantitative PET
Masashi Takasawa,P. Simon Jones,Joseph V. Guadagno,Soren Christensen,Tim D. Fryer,Sally G. Harding,Jonathan H. Gillard,Guy B. Williams,Franklin I. Aigbirhio,Elizabeth A. Warburton,Leif Østergaard,Jean-Claude Baron +11 more
TL;DR: In this article, the authors compared the cerebral blood flow (CBF), cerebral blood volume, and mean transit time (MTT) maps generated by pMR (deconvolution method) and PET (15 O steady-state method) in 5 patients studied back-to-back with the two modalities at a mean of 16 hours (range, 7 to 21 hours) after stroke onset.
Journal ArticleDOI
Comparison of 10 Different Magnetic Resonance Perfusion Imaging Processing Methods in Acute Ischemic Stroke Effect on Lesion Size, Proportion of Patients With Diffusion/Perfusion Mismatch, Clinical Scores, and Radiologic Outcomes
Ingrid Kane,Trevor Carpenter,Francesca Chappell,Carly S. Rivers,Paul A. Armitage,Peter Sandercock,Joanna M. Wardlaw +6 more
TL;DR: Perfusion lesion size differs markedly depending on the parameter calculated, and some parameters (mainly representing MTT measures) were correlation with clinical scores; others were correlated with final infarct size; and arrival time fitted was correlated with both.
References
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Intravenous Thrombolysis With Recombinant Tissue Plasminogen Activator for Acute Hemispheric Stroke: The European Cooperative Acute Stroke Study (ECASS)
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Book
Functional Magnetic Resonance Imaging
TL;DR: In this paper, the authors present an introduction to fMRI and discuss ethical issues in fMRI research, including Signal, Noise, and Preprocessing of fMRI data, data-driven approaches, and Converging Operations.