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Stroke penumbra defined by an MRI-based oxygen challenge technique: 2. Validation based on the consequences of reperfusion

Author(s): C. A. Robertson, C. McCabe, L. Gallagher, R. Lopez-Gonzalez Mdel, W. M. Holmes, B. Condon, K. W. Muir, C. Santosh, I. M. Macrae

Abstract:
Magnetic resonance imaging (MRI) with oxygen challenge (T(2)(*) OC) uses oxygen as a metabolic biotracer to define penumbral tissue based on CMRO(2) and oxygen extraction fraction. Penumbra displays a greater T(2)(*) signal change during OC than surrounding tissue. Since timely restoration of cerebral blood flow (CBF) should salvage penumbra, T(2)(*) OC was tested by examining the consequences of reperfusion on T(2)(*) OC-defined penumbra. Transient ischemia (109 +/- 20 minutes) was induced in male Sprague-Dawley rats (n=8). Penumbra was identified on T(2)(*)-weighted MRI during OC. Ischemia and ischemic injury were identified on CBF and apparent diffusion coefficient maps, respectively. Reperfusion was induced and scans repeated. T(2) for final infarct and T(2)(*) OC were run on day 7. T(2)(*) signal increase to OC was 3.4% in contralateral cortex and caudate nucleus and was unaffected by reperfusion. In OC-defined penumbra, T(2)(*) signal increased by 8.4% +/- 4.1% during ischemia and returned to 3.25% +/- 0.8% following reperfusion. Ischemic core T(2)(*) signal increase was 0.39% +/- 0.47% during ischemia and 0.84% +/- 1.8% on reperfusion. Penumbral CBF increased from 41.94 +/- 13 to 116.5 +/- 25 mL per 100 g per minute on reperfusion. On day 7, OC-defined penumbra gave a normal OC response and was located outside the infarct. T(2)(*) OC-defined penumbra recovered when CBF was restored, providing further validation of the utility of T(2)(*) OC for acute stroke management.

Full version: Available here

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ISBN: 1559-7016 (Electronic) 0271-678X (Linking)
Publication Year: 2011
Periodical: J Cereb Blood Flow Metab
Periodical Number: 8
Volume: 31
Pages: 1788-98
Author Address: Glasgow Experimental MRI Centre, Institute of Neuroscience and Psychology, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK. c.robertson.1@research.gla.ac.uk