Comparison of MRI perfusion imaging and single photon emission computed tomography in chronic stroke.
There have been few direct comparisons between MR perfusion-weighted imaging (PWI) and established perfusion imaging techniques, and none in chronic stroke. We therefore studied 17 chronic hemispheric infarction patients (mean, 90 days) and compared hypoperfusion volumes determined from PWI maps of relative cerebral blood flow (rCBF) and volume (rCBV), and mean transit time (rMTT) with those measured with (99)Tc-HMPAO single photon emission computed tomography (SPECT). Comparisons were also made between infarct size (T(2)-WI) and clinical scales. Correlations were found between lesion location and volume in all three PWI hemodynamic parameter maps with clinical state and lesions on SPECT and T(2)-WI. In 3 patients, rCBF and rCBV lesions extended well beyond the borders of moderate-sized infarctions. We conclude that in chronic stroke, PWI can delineate regions of abnormal perfusion that reflect the degree of functional impairment and structural damage. The finding of peri-infarct hypoperfusion suggests that PWI may have the potential to provide a rapid and non-invasive template against which interventional strategies aimed at promoting functional recovery may be investigated.
Department of Neurology, Royal Melbourne Hospital and University of Melbourne, Parkville, Vic. 3050, Australia.
P A
PA
Barber
H K
HK
Consolo
Q
Q
Yang
D G
DG
Darby
P M
PM
Desmond
M
M
Lichtenstein
B M
BM
Tress
S M
SM
Davis
D000368:Aged; D000369:Aged, 80 and over; D020520:Brain Infarction / Q000000981:diagnostic imaging* / Q000378:metabolism / Q000473:pathology*; D002560:Cerebrovascular Circulation; D002908:Chronic Disease; D003287:Contrast Media; D005260:Female; D019786:Gadolinium DTPA; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008875:Middle Aged; D019275:Radiopharmaceuticals; D019690:Technetium Tc 99m Exametazime; D015899:Tomography, Emission-Computed, Single-Photon
D003287:Contrast Media; D019275:Radiopharmaceuticals; D019690:Technetium Tc 99m Exametazime; D019786:Gadolinium DTPA