Penumbra detection using PWI/DWI mismatch MRI in a rat stroke model with and without comorbidity: comparison of methods

Reid, E., Graham, D. , Lopez-Gonzalez, M. R., Holmes, W. M. , Macrae, I. M. and McCabe, C. (2012) Penumbra detection using PWI/DWI mismatch MRI in a rat stroke model with and without comorbidity: comparison of methods. Journal of Cerebral Blood Flow and Metabolism, 32(9), pp. 1765-1777. (doi:10.1038/jcbfm.2012.69) (PMID:22669479) (PMCID:PMC3434632)

Full text not currently available from Enlighten.

Abstract

Perfusion-diffusion (perfusion-weighted imaging (PWI)/diffusion-weighted imaging (DWI)) mismatch is used to identify penumbra in acute stroke. However, limitations in penumbra detection with mismatch are recognized, with a lack of consensus on thresholds, quantification and validation of mismatch. We determined perfusion and diffusion thresholds from final infarct in the clinically relevant spontaneously hypertensive stroke-prone (SHRSP) rat and its normotensive control strain, Wistar-Kyoto (WKY) and compared three methods for penumbra calculation. After permanent middle cerebral artery occlusion (MCAO) (WKY n=12, SHRSP n=15), diffusion-weighted (DWI) and perfusion-weighted (PWI) images were obtained for 4 hours post stroke and final infarct determined at 24 hours on T(2) scans. The PWI/DWI mismatch was calculated from volumetric assessment (perfusion deficit volume minus apparent diffusion coefficient (ADC)-defined lesion volume) or spatial assessment of mismatch area on each coronal slice. The ADC-derived lesion growth provided the third, retrospective measure of penumbra. At 1 hour after MCAO, volumetric mismatch detected smaller volumes of penumbra in both strains (SHRSP: 31 ± 50 mm(3), WKY: 22 ± 59 mm(3), mean ± s.d.) compared with spatial assessment (SHRSP: 36 ± 15 mm(3), WKY: 43 ± 43 mm(3)) and ADC lesion expansion (SHRSP: 41 ± 45 mm(3), WKY: 65 ± 41 mm(3)), although these differences were not statistically significant. Spatial assessment appears most informative, using both diffusion and perfusion data, eliminating the influence of negative mismatch and allowing the anatomical location of penumbra to be assessed at given time points after stroke.

Item Type:Articles
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Macrae, Professor I Mhairi and Holmes, Dr William and Graham, Dr Delyth and Reid, Dr Emma and McCabe, Dr Chris
Authors: Reid, E., Graham, D., Lopez-Gonzalez, M. R., Holmes, W. M., Macrae, I. M., and McCabe, C.
College/School:College of Medical Veterinary and Life Sciences > Institute of Cardiovascular and Medical Sciences
College of Medical Veterinary and Life Sciences > Institute of Neuroscience and Psychology
College of Medical Veterinary and Life Sciences > School of Life Sciences
Journal Name:Journal of Cerebral Blood Flow and Metabolism
Journal Abbr.:J. Cereb. Blood Flow Metab.
Publisher:Nature Publishing Group
ISSN:0271-678X
ISSN (Online):1559-7016
Published Online:06 June 2012

University Staff: Request a correction | Enlighten Editors: Update this record