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Detecting the subregion proceeding to infarction in hypoperfused cerebral tissue: a study with diffusion and perfusion weighted MRI

  • Diagnostic Neuroradiology
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Abstract

Diffusion and perfusion weighted MRI have been widely used in ischaemic stroke. We studied 17 patients in whom ischaemic areas showed an ischaemic core, an area of infarct growth and hypoperfused but ultimately surviving tissue. Apparent diffusion coefficients (ADC) were measured on days 1, 2, and 8 in the three subregions and in contralateral control areas. Cerebral blood flow (CBF), cerebral blood volume (CBV), and mean transit time (MTT) were measured in these regions on day 1 perfusion maps. On day 1, the ischaemic core had very low ADC and CBF and increased MTT. The ADC in the ischaemic core gradually increased during the week. The area of infarct growth on day 1 had slightly but significantly decreased ADC (96% of control, P=0.028), moderately decreased CBF and increased MTT. On day 1 the hypoperfused but surviving tissue had slightly but significantly increased ADC (103% of control, P=0.001), mildly decreased CBF and increased CBV and MTT. The ADC of the area of infarct growth decreased to the same level as in the ischaemic core on days 2 and 8. That of surviving tissue was still above normal on day 2 (103% of control), but had returned to the normal level by day 8. Measurement of ADC combined with perfusion MRI may help distinguish different subregions in acutely hypoperfused brain.

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Fig. 1A–D.
Fig. 2A–C.

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Acknowledgements

This work was supported by Kuopio University Hospital (EVO funding 307/97 and 21/98), the Radiological Society of Finland, the Academy of Finland, the Sigrid Jusélius Foundation, the Instrumentarium Science Foundation, Biomedicum Helsinki Foundation, the Aarne Koskelo Foundation, the Paulo Foundation, and the Paavo Nurmi Foundation.

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Authors and Affiliations

  1. Department of Clinical Radiology, Kuopio University Hospital, P.O. Box 1777, 70211 , Kuopio, Finland

    Y. Liu, J. O. Karonen, R. L. Vanninen, P. A. Vainio, S. Soimakallio & H. J. Aronen

  2. Department of Radiology, Mikkeli Central Hospital, Mikkeli, Finland

    J. O. Karonen

  3. Department of Neurology, Kuopio University Hospital, Kuopio, Finland

    J. Nuutinen

  4. Department of Radiology, Helsinki University Central Hospital, Finland

    J. Perkiö & H. J. Aronen

  5. Department of Physical Sciences, University of Helsinki, Finland

    J. Perkiö

  6. Functional Brain Imaging Unit, Helsinki Brain Research Centre, Finland

    J. Perkiö & H. J. Aronen

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  1. Y. Liu
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  2. J. O. Karonen
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  3. R. L. Vanninen
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  8. H. J. Aronen
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Correspondence to Y. Liu.

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Liu, Y., Karonen, J.O., Vanninen, R.L. et al. Detecting the subregion proceeding to infarction in hypoperfused cerebral tissue: a study with diffusion and perfusion weighted MRI. Neuroradiology 45, 345–351 (2003). https://doi.org/10.1007/s00234-003-0959-3

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  • DOI: https://doi.org/10.1007/s00234-003-0959-3

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