Imaging the Ischemic Penumbra

Rivista di Neuroradiologia

Volumn 16, Issue 5, 2003, Pages 833-838

  Lövblad, Karl Olof ^a,b   Kiefer, C ^a   Oswald, H ^a   Arnold, M ^a   Nedeltchev, K ^a   Mattle, H ^a   Schroth, G ^a  

^a UNIVERSITY OF BERN   (Switzerland)

^b GENEVA UNIVERSITY HOSPITALS   (Switzerland)

Author keywords

Brain ischemia; MRI; Stroke

Indexed keywords

ADENOSINE TRIPHOSPHATASE (POTASSIUM SODIUM); FIBRINOLYTIC AGENT; UROKINASE;

BRAIN BLOOD FLOW; BRAIN EDEMA; BRAIN ISCHEMIA; CEREBROVASCULAR ACCIDENT; COMPUTER ASSISTED TOMOGRAPHY; CONFERENCE PAPER; DIFFUSION WEIGHTED IMAGING; FIBRINOLYTIC THERAPY; HUMAN; NUCLEAR MAGNETIC RESONANCE IMAGING; POSITRON EMISSION TOMOGRAPHY; SINGLE PHOTON EMISSION COMPUTER TOMOGRAPHY; STROKE;

EID: 0442279254     PISSN: 11209976     EISSN: None     Source Type: Journal    
DOI: 10.1177/197140090301600534     Document Type: Conference Paper

References (87)

1. The National Institute of Neurological Disorders and Stroke rt-PA Stroke Study Group. Tissue plasminogen activator for acute ischemic stroke. N Engl J Med 333: 1581-1587, 1995.
2. Gonner F, Remonda L et Al: Local intra-arterial thrombolysis in acute ischemic stroke. Stroke 29: 1894-1900, 1998.
3. Furlan A, Higashida R et Al: Intra-arterial prourokinase for acute ischemic stroke. The PROACT II study: a randomized controlled trial. Prolyse in Acute Cerebral Thromboembolism. JAMA 282: 2003-2011, 1999.
4. a Arnold M, Nedeltchev K et Al: Intra-arterial thrombolysis in a series of 130 patients with acute ischemic stroke. Cerebrovasc Dis 11(suppl 4): 120, 2001.
5. von Kummer R, Bourquain H et Al: Early Prediction of Irreversible Brain Damage After Ischemic Stroke by Computed Tomography. Radiology 219: 95-100, 2001.
6. von Kummer R, Bozzao L, Manelfe C: Early CT diagnosis in hemispheric brain infarction. Springer 1995.
7. von Kummer R, Meyding-Lamadé U et Al: Sensitivity and prognostic value of early computed tomography in middle cerebral artery trunk occlusion. Am J Neuroradiol 15: 9-15, 1994.
8. Unger E, Littlefield J, Gado M: Water content and water structure in CT and MR signal changes: Possible influence in detection of early stroke. Am J Neuroradiol 9: 687-691, 1988.
9. Rieth KG, Fujiwara K et Al: Serial measurements of CT attenuation and specific gravity in experimental cerebral oedema. Radiology 135: 343-348, 1980.
10. von Kummer R, Allen KL et Al: Acute stroke: usefulness of early CT findings before thrombolytic therapy. Radiology 205: 327-333, 1997.
11. von Kummer R, Holle R et Al: Inter-observer agreement in assessing early CT signs of middle cerebral artery infarction. Am J Neuroradiol 17 (9):1743, 1996.
12. Marks MP, Holmgren EB et Al: Evaluation of early computed tomographic findings in acute ischemic stroke. Stroke 30 (2): 389-392, 1992.
13. Caplan LR, Mohr JP et Al: Thrombolysis-not a panacea for ischemic stroke. New England Journal of Medicine 337: 1309-1310, 1997.
14. Yuh W, Crain M et Al: MR imaging of cerebral ischemia: Findings in the first 24 hours. Am J Neuroradiol 12: 621-629, 1991.
15. Kertesz A, Black S et Al: The sensitivity and specificity of MRI in stroke. Neurology 37: 1580-1585, 1987.
16. Bryan N, Levy L et Al: Diagnosis of acute cerebral infarction: Comparison of CT and MR Imaging. Am J Neuroradiol 12: 611-620, 1991.
17. Mohr J, Biller J et Al: Magnetic resonance versus computed tomographic imaging in acute stroke. Stroke 26: 807-812, 1995.
18. Patel MR, Edelman RR, Warach S: Detection of hyperacute primary intraparenchymal haemorrhage by magnetic resonance imaging. Stroke 27 (12): 2321-2324, 1996.
19. Linfante I, Llinas RH et Al: MRI features of intracerebral haemorrhage within 2 hours from symptom onset. Stroke 30 (11): 2263-2267, 1999.
20. El-Koussy M, Guzman R et Al: CT and MRI in acute haemorrhagic stroke. Cerebrovasc Dis 10 (6): 480-482, 2000.
21. Remonda L, Heid O, Schroth G: Carotid artery stenosis, occlusion, and pseudo-occlusion: first-pass, gadolinium-enhanced, three-dimensional MR angiography-preliminary study. Radiology 209 (1): 95-102, 1998.
22. Schellinger PD, Jansen O et Al: A standardized MRI stroke protocol: comparison with CT in hyperacute intracerebral haemorrhage. Stroke 30 (4): 765-768, 1999.
23. Schellinger PD, Jansen O et Al: Feasibility and practicality of MR imaging of stroke in the management of hyperacute cerebral ischemia. Am J Neuroradiol 21 (7):1184-1189, 2000.
24. Astrup J, Siesjo BK, Symon L: Thresholds in cerebral ischemia - the ischemic penumbra. Stroke 12: 723-725, 1981.
25. Heiss WD: Ischemic penumbra: evidence from functional imaging in man. J Cereb Blood Flow Metab 20 (9):1276-1293, 2000.
26. Heiss WD, Emunds HG, Herholz K: Cerebral glucose metabolism as a predictor of rehabilitation after ischemic stroke. Stroke 24 (12): 1784-1788, 1993.
27. Baird AE, Austin MC et Al: Changes in cerebral tissue perfusion during the first 48 hours of ischaemic stroke: relation to clinical outcome. J Neurol Neurosurg Psychiatry 61 (1): 26-29, 1996.
28. Heiss WD, Grond M et Al: Tissue at risk of infarction rescued by early reperfusion: a positron emission tomography study in systemic recombinant tissue plasminogen activator thrombolysis of acute stroke. J Cereb Blood Flow Metab 18 (12): 1298-1307, 1998.
29. Baron JC, Bousser MG et Al: Reversal of focal "misery-perfusion syndrome" by extra-intracranial arterial bypass in haemodynamic cerebral ischemia. A case study with 150 positron emission tomography. Stroke 12 (4): 454-459, 1981.
30. Heiss WD, Graf R et Al: Dynamic penumbra demonstrated by sequential multitracer PET after middle cerebral artery occlusion in cats. J Cereb Blood Flow Metab 14 (6):892-902, 1994.
31. Heiss WD, Huber M et Al: Progressive derangement of periinfarct viable tissue in ischemic stroke. J Cereb Blood Flow Metab 12 (2):193-203, 1992.
32. Baron JC, von Kummer R, del Zoppo GJ: Treatment of acute ischemic stroke. Challenging the concept of a rigid and universal time window. Stroke 26 (12): 2219-2221, 1995.
33. Heiss WD, Thiel A et Al: Which targets are relevant for therapy of acute ische-mic stroke? Stroke 31 (4): 984-986, 2000.
34. Herholz K, Heiss WD: Functional imaging correlates of recovery after stroke in humans. J Cereb Blood Flow Metab 20 (12): 1619-1631, 2000.
35. Alexandrov AV, Grotta JC et Al: Brain SPECT and thrombolysis in acute ischemic stroke: time for a clinical trial. J Nucl Med 37 (7): 1259-1262, 1996.
36. Edelman RR, Wielopolski P, Schmitt F: Echo-planar MR imaging. Radiology 192 (3): 600-612, 1994.
37. Kamada K, Saguer M et Al: Functional and metabolic analysis of cerebral ischemia using magnetoencephalography and proton magnetic resonance spectroscopy. Ann Neurol 42 (4): 554-563, 1997.
38. Le Bihan D, Breton E et Al: MR Imaging of intravoxel incoherent motions: application to diffusion and perfusion in neurologic disorders. Radiology 161: 401-407, 1986.
39. Le Bihan D: Theoretical principles of perfusion imaging Application to magnetic resonance imaging. Investigative Radiology 27: 6-11, 1992.
40. Rosen BR, Belliveau JW et Al: Perfusion Imaging with NMR contrast agents. Magn Reson Med 14: 249-265, 1990.
41. Ostergaard L, Weisskoff RM et Al: High resolution measurement of cerebral blood flow using intravascular tracer bolus passages. Part I: Mathematical approach and statistical analysis. Magn Reson Med 36: 715-725, 1996.
42. Ostergaard L, Sorensen AG et Al: High resolution measurement of cerebral blood flow using intravascular tracer bolus passages. Part II: Experimental comparison and preliminary results. Magn Reson Med 36: 726-736, 1996.
43. Lutsep HL, Albers GW et Al: Clinical utility of diffusion-weighted magnetic resonance imaging in the assessment of ischemic stroke. Ann Neurol 41 (5): 574-580, 1997.
44. Edelman RR, Siewert B et Al: Qualitative mapping of cerebral blood flow and functional localization with echo-planar MR imaging and signal targeting with alternating radio frequency. Radiology 192 (2): 513-520, 1994.
45. Sorensen AG, Copen WA et Al: Hyperacute stroke: simultaneous measurement of relative cerebral blood volume, relative cerebral blood flow, and mean tissue transit time. Radiology 210: 519-52527, 1999.
46. Ostergaard L, Sorensen AG et Al: Combined diffusion-weighted and perfusion-weighted flow heterogeneity magnetic resonance imaging in acute stroke. Stroke 31: 1097-1103, 2000.
47. Tanner JE, Stejskal EO: Restricted self-diffusion of protons in colloidal systems by the pulsed-gradient, spin-echo method: 1768-1777, 1968.
48. Moseley ME, Cohen Y et Al: Early detection of regional cerebral ischemia in cats: Comparison of diffusion- and T2-weighted MRI and spectroscopy. MRM 14: 330-346, 1990.
49. Dardzinski BJ, Sotak CH et Al: Apparent diffusion coefficient mapping of experimental focal cerebral ischemia using diffusion-weighted echo-planar imaging. MRM 318-325, 1993.
50. Minematsu K, Fisher M et Al: Effects of a novel NMDA antagonist on experimental stroke rapidly and quantitatively assessed by diffusion-weighted MRI. Neurology 43: 397-403, 1993.
51. Hasegawa Y, Fisher M et Al: MRI diffusion mapping of reversible and irreversible injury in focal brain ischemia. Neurology 44: 1484-1490, 1994.
52. Takano K, Carano RAD et Al: Efficacy of intra-arterial and intravenous prourokinase in an embolic stroke model evaluated by diffusion-perfusion magnetic resonance imaging. Neurology 50: 870-875, 1998.
53. Warach S, Chien D et Al: Fast magnetic resonance diffusion-weighted imaging of acute stroke. Neurology 42: 1717-1723, 1992.
54. Chien D, Kwong KK et Al: MR diffusion imaging of cerebral infarction in humans. Am J Neuroradiol 13 (4): 1097-1102, 1992.
55. Mansfield P: Multi-planar image formation using NMR spin echoes. J Phys C: Solid State Phys 10: L55-L58, 1977.
56. Turner R, LeBihan D et Al: Echo-planar imaging of intravoxel incoherent motion. Radiology 177: 407-414, 1990.
57. Warach S, Gaa J et Al: Acute human stroke studies by whole brain echo planar diffusion-weighted magnetic resonance imaging. Ann Neurol 37: 231-241, 1995.
58. Warach SJ, Dashe JF, Edelman RR: Clinical outcome in ischemic stroke predicted by early diffusion-weighted and perfusion magnetic resonance imaging: a preliminary analysis. J Cerebral Blood Flow and Metabolism 16: 53-59, 1996.
59. Sorensen AG, Buonano FS et Al: Hyperacute stroke: Evaluation with combined multisection diffusion-weighted and haemodynamically-weighted echo-planar MR imaging. Radiology 199: 391-401, 1996.
60. Schlaug G, Siewert B et Al: Time course of the apparent diffusion coefficient (ADC) abnormality in human stroke. Neurology 49: 113-119, 1997.
61. Lövblad KO, Laubach HJ et Al: Clinical experience with diffusion weighted MR in patients with acute stroke. Am J Neuroradiol 19: 1061-1066, 1998.
62. Jakob PM, Lövblad KO et Al: Diffusions-gewichtete Bildgebung beim akuten Hirnschlag. Der Nervenarzt 69: 683-693, 1998.
63. Lövblad KO, Jakob PM et Al: Imagerie fonctionelle de diffusion par résonance magnétique nucléaire dans l'accident vasculaire cérébral aigu. Schweizer Archiv für Neurologie und Psychiatrie 147: 143-151, 1997.
64. Ay H, Buonanno FS et Al: Normal diffusion-weighted MRI during stroke-like deficits. Neurol 10, 52: 1784-1792, 1999.
65. Oppenheim C, Stanescu R et Al: False-negative diffusion-weighted MR findings in acute ischemic stroke. Am J Neuroradiol 21: 1434-1440, 2000.
66. Kidwell C, Alger J et Al: Diffusion MRI in patients with transient ischemic attacks. Stroke 30: 1174-1180, 1999.
67. Warach S, Wielopolski P, Edelman RR: Identification and characterization of the ischemic penumbra of acute human stroke using echo planar diffusion and perfusion imaging. In: Proceedings of the 12th annual meeting of the Society of Magnetic Resonance in Medicine: 263, Berkeley, Ca, 1993.
68. Schlaug G, Benfield A et Al: The ischemic penumbra of human stroke: using functional MRI parameters to define tissue at risk for infarct progression. Neurology 53: 1528-1537, 1999.
69. Rordorf G, Koroshetz WJ et Al: Time course of lesion development in patients with acute stroke: serial diffusion- and haemodynamic-weighted magnetic resonance imaging. Stroke 29 (11): 2268-2276, 1998.
70. Schwamm LH, Koroshetz WJ et Al: Regional ischemia and ischemic injury in patients with acute middle cerebral artery stroke as defined by early diffusion-weighted and perfusion-weighted MRI. Stroke 29 (5): 939-943, 1998.
71. Karonen JO, Liu Y et Al: Combined perfusion- and diffusion-weighted MR imaging in acute ischemic stroke during the 1st week: a longitudinal study. Radiology 217 (3): 886-894, 2000.
72. Karonen JO, Vanninen RL et Al: Combined diffusion and perfusion MRI with correlation to single-photon emission CT in acute ischemic stroke. Ischemic penumbra predicts infarct growth. Stroke 30 (8): 1583-1590, 1999.
73. Karonen JO, Ostergaard L et Al: Diffusion and perfusion MR imaging in acute ischemic stroke: a comparison to SPECT. Comput Methods Programs Biomed 66 (1):125-128, 2001.
74. Liu Y, Karonen JO et Al: Cerebral haemodynamics in human acute ischemic stroke: a study with diffusion- and perfusion-weighted magnetic resonance imaging and SPECT. J Cereb Blood Flow Metab 20 (6):910-920, 2000.
75. Nallet H, MacKenzie ET, Roussel S: The nature of penumbral depolarizations following focal cerebral ischemia in the rat: Brain Res 18; 842 (1):148-158, 1999.
76. Strong AJ, Smith SE et Al: Factors influencing the frequency of fluorescence transients as markers of peri-infarct depolarizations in focal cerebral ischemia. Stroke 31: 214-222, 2000.
77. Back T, Hirsch JG et Al: Failure to demonstrate peri-infarct depolarizations by repetitive MR diffusion imaging in acute human stroke. Stroke 31 (12): 2901-2906, 2000.
78. Wu O, Koroshetz WJ et Al: Predicting tissue outcome in acute human cerebral ischemia using combined diffusion- and perfusion-weighted MR imaging. Stro-ke 32: 933-942, 2001.
79. El Koussy M, Kiefer C et Al: DWI in acute ischemic stroke: Improving the evaluation of the penumbral diffusion effect. Neuroradiology 42: S42, 2000.
80. El-Koussy M, Kiefer C et Al: Weighted ADC mapping improves the evaluation of the ischemic penumbra in acute stroke. ESNR 2001, Neuroradiology 2001 in press.
81. Sorensen AG, Wu O et Al: Human acute cerebral ischemia: detection of changes in water diffusion anisotropy by using MR imaging. Radiology 212: 785-792, 1992.
82. Marks MP, Tong DC et Al: Evaluation of early reperfusion and IV tPA therapy using diffusion- and perfusion-weighted MRI. Neurology 52: 1792-1798, 1999.
83. Kidwell CS, Saver JL et Al: Thrombolytic reversal of acute human cerebral ischemic injury shown by diffusion/perfusion magnetic resonance imaging. Ann Neurol 47: 462-469, 2000.
84. Lansberg MG, Tong DC et Al: Intra-arterial rtPA treatment of stroke assessed by diffusion- and perfusion-weighted MRI. Stroke 30: 678-680, 1999.
85. Schellinger PD, Jansen O et Al: Monitoring intravenous recombinant plasminogen activator thrombolysis for acute ischemic stroke with diffusion and perfusion MRI. Stroke 31: 1318-1328, 2000.
86. Jansen O, Schellinger P et Al: Early recanalisation in acute ischaemic stroke saves tissue at risk defined by MRI. Lancet 12; 353 (9169): 2036-2037, 1999.
87. Taleb M, Lövblad KO et Al: Reperfusion demonstrated by ADC mapping after intra-arterial thrombolysis for human ischemic stroke confirmed by cerebral angiography. Neuroradiology 43: 591-594, 2001.