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

Craig A Robertson, Christopher McCabe, Lindsay Gallagher, Maria del Rosario Lopez-Gonzalez, William M Holmes, Barrie Condon, Keith W Muir, Celestine Santosh, I Mhairi Macrae

Research output: Contribution to journalArticle

27 Citations (Scopus)

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.

Original languageEnglish
Pages (from-to)1788-1798
Number of pages11
JournalJournal of Cerebral Blood Flow and Metabolism
Volume31
Issue number8
Early online date11 May 2011
DOIs
Publication statusPublished - Aug 2011

Keywords

  • animals
  • brain ischemia
  • cerebrovascular circulation
  • iIschemic attack, transient
  • Magnetic resonance imaging
  • male
  • oxygen
  • rats
  • stroke

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