Time course of circulatory and metabolic recovery of cat brain after cardiac arrest assessed by perfusion- and diffusion-weighted imaging and MR-spectroscopy.
Brain recovery after cardiac arrest (CA) was assessed in cats using arterial spin tagging perfusion-weighted imaging (PWI), diffusion-weighted imaging (DWI), and 1H-spectroscopy (1H-MRS). Cerebral reperfusion and metabolic recovery was monitored in the cortex and in basal ganglia for 6 h after cardiopulmonary resuscitation (CPR). Furthermore, the effects of an hypertonic/hyperoncotic solution (7.5% NaCl/6% hydroxyl ethyl starch, HES) and a tissue-type plasminogen activator (TPA), applied during CPR, were assessed on brain recovery. CA and CPR were carried out in the MR scanner by remote control. CA for 15-20 min was induced by electrical fibrillation of the heart, followed by CPR using a pneumatic vest. PWI after successful CPR revealed initial cerebral hyperperfusion followed by delayed hypoperfusion. Initial cerebral recirculation was improved after osmotic treatment. Osmotic and thrombolytic therapy were ineffective in ameliorating delayed hypoperfusion. Calculation of the apparent diffusion coefficient (ADC) from DWI demonstrated complete recovery of ion and water homeostasis in all animals. 1H-MRS measurements of lactate suggested an extended preservation of post-ischaemic anaerobic metabolism after TPA treatment. The combination of noninvasive MR techniques is a powerful tool for the evaluation of therapeutical strategies on circulatory and metabolic cerebral recovery after experimental cerebral ischaemia.
Krep
Henning
H
Department of Anesthesia and Intensive Care Medicine, University Hospital Bonn, Bonn, Germany. h.krep@ukb.uni-bonn.de
Böttiger
Bernd W
BW
Bock
Christian
C
Kerskens
Christian M
CM
Radermacher
Bernd
B
Fischer
Matthias
M
Hoehn
Mathias
M
Hossmann
Konstantin Alexander
KA
D000818:Animals; D001921:Brain / Q000098:blood supply / Q000378:metabolism; D016887:Cardiopulmonary Resuscitation / Q000379:methods; D002415:Cats; D002560:Cerebrovascular Circulation / Q000502:physiology; D004195:Disease Models, Animal; D006323:Heart Arrest / Q000150:complications* / Q000628:therapy; D020925:Hypoxia-Ischemia, Brain / Q000175:diagnosis* / Q000209:etiology / Q000378:metabolism; D008279:Magnetic Resonance Imaging / Q000379:methods*