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Magnetic resonance perfusion-weighted imaging is a more sensitive method than conventional CT and MR imaging. While the latter can detect acute intracranial hemorrhage, they are not sufficiently sensitive to evaluate acute ischemic stroke immediately after it occurs.
Current Knowledge
Traditional scanning methods may initially be negative – for the first 24–36 h for CT and for the first 6–12 h for MR. Given that most new acute stroke therapies must be implemented during the first 3–4 h after onset, two important objectives of imaging are to define early and quickly the area of brain infarction and perfusion deficit and to identify any ischemic tissue that can be salvaged by medical, surgical, or endovascular therapy. Perfusion imaging is positive immediately following an acute stroke.
The difference between diffusion and perfusion abnormalities provides a measure of the ischemic penumbra or the brain tissue that has been injured but has reversible ischemia. This...
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References
Albers, G. W., Thijs, V. N., Wechsler, L., Kemp, S., Schlaug, G., et al. (2006). Magnetic resonance imaging profiles predict clinical response to early reperfusion: The diffusion and perfusion imaging evaluation for understanding stroke evolution (DEFUSE) study. Annals of Neurology, 60, 508–517.
Campbell, B. C. V., Mitchell, P. J., Kleinig, T. J., Dewey, H. M., Churilov, L., et al. (2015). Endovascular therapy for ischemic stroke with perfusion-imaging selection. The New England Journal of Medicine, 372, 1009–1018.
Wintermark, M., Reichhart, M., Cuisenaire, O., Maeder, P., Thiran, J.-P., Schnyder, P., Bogousslavsky, J., & Meuli, R. (2002). Comparison of admission perfusion computed tomography and qualitative diffusion- and perfusion weighted magnetic resonance imaging in acute stroke patients. Stroke, 33, 2025–2031.
Wu, O., Koroshetz, W. J., Østergaard, L., Buonanno, F. S., Copen, S. A., Gonzalez, R. G., Rordorf, G., Rosen, B. R., Schwamm, L. H., Weisskoff, R. M., & Sorensen, A. G. (2001). Predicting tissue outcome in acute human cerebral ischemia using combined diffusion- and perfusion-weighted MR imaging. Stroke, 32, 933–942.
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Roth, E. (2018). Perfusion-Weighted Imaging. In: Kreutzer, J., DeLuca, J., Caplan, B. (eds) Encyclopedia of Clinical Neuropsychology. Springer, Cham. https://doi.org/10.1007/978-3-319-56782-2_2194-2
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DOI: https://doi.org/10.1007/978-3-319-56782-2_2194-2
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