Mapping of cerebral metabolic rate of oxygen using dynamic susceptibility contrast and blood oxygen level dependent MR imaging in acute ischemic stroke

Alexandra S. Gersing, Monika Ankenbrank, Benedikt J. Schwaiger, Vivien Toth, Insa Janssen, Hendrik Kooijman, Silke Wunderlich, Jan S. Bauer, Claus Zimmer, Christine Preibisch

Research output: Contribution to journalArticlepeer-review

22 Scopus citations

Abstract

Introduction: MR-derived cerebral metabolic rate of oxygen utilization (CMRO2) has been suggested to be analogous to PET-derived CMRO2 and therefore may be used for detection of viable tissue at risk for infarction. The purpose of this study was to evaluate MR-derived CMRO2 mapping in acute ischemic stroke in relation to established diffusion- and perfusion-weighted imaging. Methods: In 23 patients (mean age 63 ± 18.7 years, 11 women) with imaging findings for acute ischemic stroke, relative oxygen extraction fraction was calculated from quantitative transverse relaxation times (T2, T2*) and relative cerebral blood volume using a quantitative blood oxygenation level dependent (BOLD) approach in order to detect a local increase of deoxyhemoglobin. Relative CMRO2 (rCMRO2) maps were calculated by multiplying relative oxygen extraction fraction (rOEF) by cerebral blood flow, derived from PWI. After co-registration, rCMRO2 maps were evaluated in comparison with apparent diffusion coefficient (ADC) and time-to-peak (TTP) maps. Mean rCMRO2 values in areas with diffusion-restriction or TTP/ADC mismatch were compared with rCMRO2 values in the contralateral tissue. Results: In tissue with diffusion restriction, mean rCMRO2 values were significantly decreased compared to perfusion-impaired (17.9 [95 % confidence interval 10.3, 25.0] vs. 58.1 [95 % confidence interval 50.1, 70.3]; P < 0.001) and tissue in the contralateral hemisphere (68.2 [95 % confidence interval 61.4, 75.0]; P < 0.001). rCMRO2 in perfusion-impaired tissue showed no significant change compared to tissue in the contralateral hemisphere (58.1 [95 % confidence interval 50.1, 70.3] vs. 66.7 [95 % confidence interval 53.4, 73.4]; P = 0.34). Conclusion: MR-derived CMRO2 was decreased within diffusion-restricted tissue and stable within perfusion-impaired tissue, suggesting that this technique may be adequate to reveal different pathophysiological stages in acute stroke.

Original languageEnglish
Pages (from-to)1253-1261
Number of pages9
JournalNeuroradiology
Volume57
Issue number12
DOIs
StatePublished - 1 Dec 2015

Keywords

  • MR imaging brain
  • Quantitative BOLD
  • Stroke

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