Identifying the ischaemic penumbra using pH-weighted magnetic resonance imaging.
The original concept of the ischaemic penumbra suggested imaging of regional cerebral blood flow and metabolism would be required to identify tissue that may benefit from intervention. Amide proton transfer magnetic resonance imaging, a chemical exchange saturation transfer technique, has been used...
| Main Authors: | , , , , , , , , , , , |
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| Format: | Journal article |
| Language: | English |
| Published: |
Oxford University Press
2015
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| _version_ | 1797087608865554432 |
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| author | Harston, G Tee, Y Blockley, N Okell, T Thandeswaran, S Shaya, G Sheerin, F Cellerini, M Payne, S Jezzard, P Chappell, M Kennedy, J |
| author_facet | Harston, G Tee, Y Blockley, N Okell, T Thandeswaran, S Shaya, G Sheerin, F Cellerini, M Payne, S Jezzard, P Chappell, M Kennedy, J |
| author_sort | Harston, G |
| collection | OXFORD |
| description | The original concept of the ischaemic penumbra suggested imaging of regional cerebral blood flow and metabolism would be required to identify tissue that may benefit from intervention. Amide proton transfer magnetic resonance imaging, a chemical exchange saturation transfer technique, has been used to derive cerebral intracellular pH in preclinical stroke models and has been proposed as a metabolic marker of ischaemic penumbra. In this proof of principle clinical study, we explored the potential of this pH-weighted magnetic resonance imaging technique at tissue-level. Detailed voxel-wise analysis was performed on data from a prospective cohort of 12 patients with acute ischaemic stroke. Voxels within ischaemic core had a more severe intracellular acidosis than hypoperfused tissue recruited to the final infarct (P50.0001), which in turn was more acidotic than hypoperfused tissue that survived (P50.0001). In addition, when confined to the grey matter perfusion deficit, intracellular pH (P50.0001), but not cerebral blood flow (P= 0.31), differed between tissue that infarcted and tissue that survived. Within the presenting apparent diffusion coefficient lesion, intracellular pH differed between tissue with early apparent diffusion lesion pseudonormalization and tissue with true radiographic recovery. These findings support the need for further investigation of pH-weighted imaging in patients with acute ischaemic stroke. |
| first_indexed | 2024-03-07T02:38:04Z |
| format | Journal article |
| id | oxford-uuid:a979af71-014a-4b83-8e3a-754885497ac4 |
| institution | University of Oxford |
| language | English |
| last_indexed | 2024-03-07T02:38:04Z |
| publishDate | 2015 |
| publisher | Oxford University Press |
| record_format | dspace |
| spelling | oxford-uuid:a979af71-014a-4b83-8e3a-754885497ac42022-03-27T03:08:44ZIdentifying the ischaemic penumbra using pH-weighted magnetic resonance imaging.Journal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:a979af71-014a-4b83-8e3a-754885497ac4EnglishSymplectic Elements at OxfordOxford University Press2015Harston, GTee, YBlockley, NOkell, TThandeswaran, SShaya, GSheerin, FCellerini, MPayne, SJezzard, PChappell, MKennedy, JThe original concept of the ischaemic penumbra suggested imaging of regional cerebral blood flow and metabolism would be required to identify tissue that may benefit from intervention. Amide proton transfer magnetic resonance imaging, a chemical exchange saturation transfer technique, has been used to derive cerebral intracellular pH in preclinical stroke models and has been proposed as a metabolic marker of ischaemic penumbra. In this proof of principle clinical study, we explored the potential of this pH-weighted magnetic resonance imaging technique at tissue-level. Detailed voxel-wise analysis was performed on data from a prospective cohort of 12 patients with acute ischaemic stroke. Voxels within ischaemic core had a more severe intracellular acidosis than hypoperfused tissue recruited to the final infarct (P50.0001), which in turn was more acidotic than hypoperfused tissue that survived (P50.0001). In addition, when confined to the grey matter perfusion deficit, intracellular pH (P50.0001), but not cerebral blood flow (P= 0.31), differed between tissue that infarcted and tissue that survived. Within the presenting apparent diffusion coefficient lesion, intracellular pH differed between tissue with early apparent diffusion lesion pseudonormalization and tissue with true radiographic recovery. These findings support the need for further investigation of pH-weighted imaging in patients with acute ischaemic stroke. |
| spellingShingle | Harston, G Tee, Y Blockley, N Okell, T Thandeswaran, S Shaya, G Sheerin, F Cellerini, M Payne, S Jezzard, P Chappell, M Kennedy, J Identifying the ischaemic penumbra using pH-weighted magnetic resonance imaging. |
| title | Identifying the ischaemic penumbra using pH-weighted magnetic resonance imaging. |
| title_full | Identifying the ischaemic penumbra using pH-weighted magnetic resonance imaging. |
| title_fullStr | Identifying the ischaemic penumbra using pH-weighted magnetic resonance imaging. |
| title_full_unstemmed | Identifying the ischaemic penumbra using pH-weighted magnetic resonance imaging. |
| title_short | Identifying the ischaemic penumbra using pH-weighted magnetic resonance imaging. |
| title_sort | identifying the ischaemic penumbra using ph weighted magnetic resonance imaging |
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