Quantitative Measurement of Cerebral Perfusion with Intravoxel Incoherent Motion in Acute Ischemia Stroke: Initial Clinical Experience

Background: Intravoxel incoherent motion (IVIM) has the potential to provide both diffusion and perfusion information without an exogenous contrast agent, its application for the brain is promising, however, feasibility studies on this are relatively scarce. The aim of this study is to assess the fe...

Full description

Bibliographic Details
Main Authors: Li-Bao Hu, Nan Hong, Wen-Zhen Zhu
Format: Article
Language:English
Published: Wolters Kluwer 2015-01-01
Series:Chinese Medical Journal
Subjects:
Online Access:http://www.cmj.org/article.asp?issn=0366-6999;year=2015;volume=128;issue=19;spage=2565;epage=2569;aulast=Hu
_version_ 1818542975829934080
author Li-Bao Hu
Nan Hong
Wen-Zhen Zhu
author_facet Li-Bao Hu
Nan Hong
Wen-Zhen Zhu
author_sort Li-Bao Hu
collection DOAJ
description Background: Intravoxel incoherent motion (IVIM) has the potential to provide both diffusion and perfusion information without an exogenous contrast agent, its application for the brain is promising, however, feasibility studies on this are relatively scarce. The aim of this study is to assess the feasibility of IVIM perfusion in patients with acute ischemic stroke (AIS). Methods: Patients with suspected AIS were examined by magnetic resonance imaging within 24 h of symptom onset. Fifteen patients (mean age was 68.7 ± 8.0 years) who underwent arterial spin labeling (ASL) and diffusion-weighted imaging (DWI) were identified as having AIS with ischemic penumbra were enrolled, where ischemic penumbra referred to the mismatch areas of ASL and DWI. Eleven different b-values were applied in the biexponential model. Regions of interest were selected in ischemic penumbras and contralateral normal brain regions. Fast apparent diffusion coefficients (ADCs) and ASL cerebral blood flow (CBF) were measured. The paired t- test was applied to compare ASL CBF, fast ADC, and slow ADC measurements between ischemic penumbras and contralateral normal brain regions. Linear regression and Pearson's correlation were used to evaluate the correlations among quantitative results. Results: The fast ADCs and ASL CBFs of ischemic penumbras were significantly lower than those of the contralateral normal brain regions (1.93 ± 0.78 αμm2/ms vs. 3.97 ± 2.49 αμm2/ms, P = 0.007; 13.5 ± 4.5 ml·100 g-1·min-1 vs. 29.1 ± 12.7 ml·100 g-1·min-1, P < 0.001, respectively). No significant difference was observed in slow ADCs between ischemic penumbras and contralateral normal brain regions (0.203 ± 0.090 αμm2/ms vs. 0.198 ± 0.100 αμm2/ms, P = 0.451). Compared with contralateral normal brain regions, both CBFs and fast ADCs decreased in ischemic penumbras while slow ADCs remained the same. A significant correlation was detected between fast ADCs and ASL CBFs (r = 0.416, P < 0.05). No statistically significant correlation was observed between ASL CBFs and slow ADCs, or between fast ADCs and slow ADCs (r = 0.111, P = 0.558; r = 0.200, P = 0.289, respectively). Conclusions: The decrease in cerebral blood perfusion primarily results in the decrease in fast ADC in ischemic penumbras; therefore, fast ADC can reflect the perfusion situation in cerebral tissues.
first_indexed 2024-12-11T22:29:13Z
format Article
id doaj.art-1b50c0bd876c42909daa196fab8f4f73
institution Directory Open Access Journal
issn 0366-6999
language English
last_indexed 2024-12-11T22:29:13Z
publishDate 2015-01-01
publisher Wolters Kluwer
record_format Article
series Chinese Medical Journal
spelling doaj.art-1b50c0bd876c42909daa196fab8f4f732022-12-22T00:48:11ZengWolters KluwerChinese Medical Journal0366-69992015-01-01128192565256910.4103/0366-6999.166033Quantitative Measurement of Cerebral Perfusion with Intravoxel Incoherent Motion in Acute Ischemia Stroke: Initial Clinical ExperienceLi-Bao HuNan HongWen-Zhen ZhuBackground: Intravoxel incoherent motion (IVIM) has the potential to provide both diffusion and perfusion information without an exogenous contrast agent, its application for the brain is promising, however, feasibility studies on this are relatively scarce. The aim of this study is to assess the feasibility of IVIM perfusion in patients with acute ischemic stroke (AIS). Methods: Patients with suspected AIS were examined by magnetic resonance imaging within 24 h of symptom onset. Fifteen patients (mean age was 68.7 ± 8.0 years) who underwent arterial spin labeling (ASL) and diffusion-weighted imaging (DWI) were identified as having AIS with ischemic penumbra were enrolled, where ischemic penumbra referred to the mismatch areas of ASL and DWI. Eleven different b-values were applied in the biexponential model. Regions of interest were selected in ischemic penumbras and contralateral normal brain regions. Fast apparent diffusion coefficients (ADCs) and ASL cerebral blood flow (CBF) were measured. The paired t- test was applied to compare ASL CBF, fast ADC, and slow ADC measurements between ischemic penumbras and contralateral normal brain regions. Linear regression and Pearson's correlation were used to evaluate the correlations among quantitative results. Results: The fast ADCs and ASL CBFs of ischemic penumbras were significantly lower than those of the contralateral normal brain regions (1.93 ± 0.78 αμm2/ms vs. 3.97 ± 2.49 αμm2/ms, P = 0.007; 13.5 ± 4.5 ml·100 g-1·min-1 vs. 29.1 ± 12.7 ml·100 g-1·min-1, P < 0.001, respectively). No significant difference was observed in slow ADCs between ischemic penumbras and contralateral normal brain regions (0.203 ± 0.090 αμm2/ms vs. 0.198 ± 0.100 αμm2/ms, P = 0.451). Compared with contralateral normal brain regions, both CBFs and fast ADCs decreased in ischemic penumbras while slow ADCs remained the same. A significant correlation was detected between fast ADCs and ASL CBFs (r = 0.416, P < 0.05). No statistically significant correlation was observed between ASL CBFs and slow ADCs, or between fast ADCs and slow ADCs (r = 0.111, P = 0.558; r = 0.200, P = 0.289, respectively). Conclusions: The decrease in cerebral blood perfusion primarily results in the decrease in fast ADC in ischemic penumbras; therefore, fast ADC can reflect the perfusion situation in cerebral tissues.http://www.cmj.org/article.asp?issn=0366-6999;year=2015;volume=128;issue=19;spage=2565;epage=2569;aulast=HuArterial Spin Labeling; Cerebral Blood Flow; Intravoxel Incoherent Motion; Ischemic Penumbra
spellingShingle Li-Bao Hu
Nan Hong
Wen-Zhen Zhu
Quantitative Measurement of Cerebral Perfusion with Intravoxel Incoherent Motion in Acute Ischemia Stroke: Initial Clinical Experience
Chinese Medical Journal
Arterial Spin Labeling; Cerebral Blood Flow; Intravoxel Incoherent Motion; Ischemic Penumbra
title Quantitative Measurement of Cerebral Perfusion with Intravoxel Incoherent Motion in Acute Ischemia Stroke: Initial Clinical Experience
title_full Quantitative Measurement of Cerebral Perfusion with Intravoxel Incoherent Motion in Acute Ischemia Stroke: Initial Clinical Experience
title_fullStr Quantitative Measurement of Cerebral Perfusion with Intravoxel Incoherent Motion in Acute Ischemia Stroke: Initial Clinical Experience
title_full_unstemmed Quantitative Measurement of Cerebral Perfusion with Intravoxel Incoherent Motion in Acute Ischemia Stroke: Initial Clinical Experience
title_short Quantitative Measurement of Cerebral Perfusion with Intravoxel Incoherent Motion in Acute Ischemia Stroke: Initial Clinical Experience
title_sort quantitative measurement of cerebral perfusion with intravoxel incoherent motion in acute ischemia stroke initial clinical experience
topic Arterial Spin Labeling; Cerebral Blood Flow; Intravoxel Incoherent Motion; Ischemic Penumbra
url http://www.cmj.org/article.asp?issn=0366-6999;year=2015;volume=128;issue=19;spage=2565;epage=2569;aulast=Hu
work_keys_str_mv AT libaohu quantitativemeasurementofcerebralperfusionwithintravoxelincoherentmotioninacuteischemiastrokeinitialclinicalexperience
AT nanhong quantitativemeasurementofcerebralperfusionwithintravoxelincoherentmotioninacuteischemiastrokeinitialclinicalexperience
AT wenzhenzhu quantitativemeasurementofcerebralperfusionwithintravoxelincoherentmotioninacuteischemiastrokeinitialclinicalexperience