title: Qualitative and quantitative analysis of MR imaging findings in patients with middle cerebral artery stroke implanted with mesenchymal stem cells.
abstract: OBJECTIVE
  Mesenchymal stem cells have potential as a regenerative therapy in ischemic stroke. We sought to determine MR imaging findings after mesenchymal stem cell implantation in chronic middle cerebral artery infarcts and to compare brain volume changes in patients with mesenchymal stem cells with those in age-matched healthy controls and controls with chronic stable MCA infarcts.
  
  
  METHODS
  We retrospectively identified 5 patients receiving surgical mesenchymal stem cell implantation to an MCA infarct from January 1, 2005, to July 1, 2013, with MR imaging immediately and 1 year postimplantation. Images at both time points were evaluated for any postimplantation complications. Structural image evaluation using normalization of atrophy software was used to determine volume changes between time points and compare them with those in healthy and age- and sex-matched controls with chronic, stable MCA infarcts by using Kruskal-Wallis and Mann-Whitney U tests.
  
  
  RESULTS
  Susceptibility signal loss and enhancement at the implantation site were seen. No teratoma, tumor, or heterotopia was identified. Volumetric analysis showed a trend toward less overall volume loss after mesenchymal stem cell implantation (0.736; 95% CI, -4.15-5.62) compared with that in age- and sex-matched controls with chronic, stable MCA infarcts (-3.59; 95% CI, -12.3 to -5.21; P = .09), with a significantly greater growth-to-loss ratio in infarcted regions (1.30 and 0.78, respectively, P = .02). A trend toward correlation of growth-to-loss ratio with improvement in physical examination findings was seen (r = 0.856, P = .06).
  
  
  CONCLUSIONS
  Postoperative changes consistent with stereotactic implantation were seen, but no teratoma, tumor, or heterotopia was identified. Initial findings suggest a trend toward less volume loss after mesenchymal stem cell implantation compared with that in age- and sex-matched controls with chronic, stable MCA infarcts, with a significantly greater growth-to-loss ratio in the infarcted tissue.
authors: From the Department of Radiology, Division of Neuroradiology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania.
authors: C P
authors: CP
authors: Wanamaker
authors: From the Department of Radiology, Division of Neuroradiology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania.
authors: S
authors: S
authors: Fakhran
authors: From the Department of Radiology, Division of Neuroradiology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania. alhilalilm@upmc.edu.
authors: L M
authors: LM
authors: Alhilali
mesh_terms: D000368:Aged; D005260:Female; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D020244:Infarction, Middle Cerebral Artery / Q000473:pathology* / Q000628:therapy*; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D045164:Mesenchymal Stem Cell Transplantation / Q000379:methods*; D008875:Middle Aged; D012189:Retrospective Studies
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