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The diffusion-weighted lesion in acute stroke: heterogeneous patterns of flow/metabolism uncoupling as assessed by quantitative positron emission tomography.
- Source :
-
Cerebrovascular diseases (Basel, Switzerland) [Cerebrovasc Dis] 2005; Vol. 19 (4), pp. 239-46. Date of Electronic Publication: 2005 Feb 22. - Publication Year :
- 2005
-
Abstract
- Background: To investigate what the hyperintense lesion in diffusion-weighted imaging (DWI) of acute ischaemic stroke represents metabolically, we prospectively imaged acute carotid-territory stroke patients with DWI along with fully quantitative positron emission tomography (PET), which gives physiological maps of cerebral blood flow (CBF), the cerebral metabolic rate of oxygen (CMRO2) and the oxygen extraction fraction (OEF).<br />Method: Of 10 patients who consented, 5 (3 males, 2 females, 53-84 years, NIHSS 6-16) completed the imaging protocol of back-to-back DWI and PET within 21 (mean 15.7, range 7-21) h of stroke onset. All images were co-registered with the DWI lesion forming a region of interest (ROI) that was transferred to the PET parametric maps (OEF, CBF, CMRO2). Patterns of blood flow and metabolism were assessed within the DWI ROI.<br />Results: Within the DWI lesions, the following patterns were observed: very low CBF and CMRO2/variable OEF; low CBF/high OEF, and high CBF/low OEF. There was a heterogeneity of patterns between and within DWI lesions. In addition, areas of hyperperfusion (with low OEF) and areas of hypoperfusion (with high OEF) were seen outside the DWI lesions.<br />Conclusion: The DWI lesion does not have a single flow/metabolism counterpart, suggesting that it reflects various stages of the ischaemic process.<br /> (Copyright 2005 S. Karger AG, Basel.)
- Subjects :
- Acute Disease
Aged
Aged, 80 and over
Brain blood supply
Brain metabolism
Brain pathology
Brain Ischemia diagnostic imaging
Brain Ischemia metabolism
Brain Ischemia pathology
Cerebrovascular Circulation
Energy Metabolism
Female
Humans
Male
Middle Aged
Oxygen metabolism
Stroke metabolism
Diffusion Magnetic Resonance Imaging
Positron-Emission Tomography
Stroke diagnostic imaging
Stroke pathology
Subjects
Details
- Language :
- English
- ISSN :
- 1015-9770
- Volume :
- 19
- Issue :
- 4
- Database :
- MEDLINE
- Journal :
- Cerebrovascular diseases (Basel, Switzerland)
- Publication Type :
- Academic Journal
- Accession number :
- 15741718
- Full Text :
- https://doi.org/10.1159/000084087