Imaging of cerebral blood flow and metabolism

Current Opinion in Anaesthesiology

Volumn 19, Issue 5, 2006, Pages 473-480

  Coles, Jonathan P ^a  

^a ADDENBROOKE S HOSPITAL   (United Kingdom)

Author keywords

Cerebral blood flow; Cerebral metabolism; Imaging; Ischaemia; Perfusion

Indexed keywords

XENON;

BRAIN BLOOD FLOW; BRAIN INJURY; BRAIN METABOLISM; BRAIN PERFUSION; COMPUTER ASSISTED TOMOGRAPHY; CONTRAST ENHANCEMENT; CRITICALLY ILL PATIENT; DIFFUSION WEIGHTED IMAGING; HUMAN; NUCLEAR MAGNETIC RESONANCE IMAGING; NUCLEAR MAGNETIC RESONANCE SPECTROSCOPY; POSITRON EMISSION TOMOGRAPHY; PRIORITY JOURNAL; REVIEW; SINGLE PHOTON EMISSION COMPUTER TOMOGRAPHY; SPIN LABELING;

BLOOD CIRCULATION TIME; BRAIN; BRAIN DISEASES; CEREBROVASCULAR CIRCULATION; DIFFUSION MAGNETIC RESONANCE IMAGING; FLUORODEOXYGLUCOSE F18; GLUCOSE; HUMANS; MAGNETIC RESONANCE IMAGING; MAGNETIC RESONANCE SPECTROSCOPY; ORGANOTECHNETIUM COMPOUNDS; OXYGEN; OXYGEN RADIOISOTOPES; PERFUSION; POSITRON-EMISSION TOMOGRAPHY; RADIOPHARMACEUTICALS; SPIN LABELS; TOMOGRAPHY, EMISSION-COMPUTED, SINGLE-PHOTON; TOMOGRAPHY, SPIRAL COMPUTED; TOMOGRAPHY, X-RAY COMPUTED; XENON;

EID: 33748640987     PISSN: 09527907     EISSN: None     Source Type: Journal    
DOI: 10.1097/01.aco.0000245270.90377.00     Document Type: Review

References (82)

1. Latchaw RE, Yonas H, Hunter GJ, et al. Guidelines and recommendations for perfusion imaging in cerebral ischemia: a scientific statement for healthcare professionals by the writing group on perfusion imaging, from the Council on Cardiovascular Radiology of the American Heart Association. Stroke 2003; 34:1084-1104.
2. Kety SS, Schmidt CF. The determination of cerebral blood flow in man by the use of nitrous oxide in low concentrations. Am J Physiol 1945; 143:53-56.
3. Drayer BP, Wolfson SK, Reinmuth OM, et al. Xenon enhanced CT for analysis of cerebral integrity, perfusion, and blood flow. Stroke 1978; 9:123-130.
4. Marion DW, Crosby K. The effect of stable xenon on ICP. J Cereb Blood Flow Metab 1991; 11:347-350.
5. von Oettingen G, Bergholt B, Ostergaard L, et al. Xenon CT cerebral blood flow in patients with head injury: influence of pulmonary trauma on the input function. Neuroradiology 2000; 42:168-173.
6. Wintermark M, Thiran JP, Maeder P, et al. Simultaneous measurement of regional cerebral blood flow by perfusion CT and stable xenon CT: a validation study. AJNR Am J Neuroradiol 2001; 22:905-914.
7. Baron JC. Stroke research in the modern era: images versus dogmas. Cerebrovasc Dis 2005; 20:154-163. Review of how physiological imaging techniques have helped to define pathophysiology and determine treatment options following acute ischaemic stroke.
8. Ohashi M, Tsuji A, Kaneko M, Matsuda M. Threshold of regional cerebral blood flow for infarction in patients with acute cerebral ischemia. J Neuroradiol 2005; 32:337-341.
9. Gupta R, Jovin TG, Yonas H. Xenon CT cerebral blood flow in acute stroke. Neuroimaging Clin N Am 2005; 15:531-542; x. Review of the use of Xenon CT following acute stroke.
10. Eskey CJ, Sanelli PC. Perfusion imaging of cerebrovascular reserve. Neuroimaging Clin N Am 2005; 15:367-381; xi. Review of methods available to assess cerebrovascular reserve and predict whether intervention is warranted to prevent cerebral infarction.
11. Al-Rawi PG, Zygun D, Tseng MY, et al. Cerebral blood flow augmentation in patients with severe subarachnoid haemorrhage. Acta Neurochir Suppl 2005; 95:123-127.
12. Inoue Y, Shiozaki T, Tasaki O, et al. Changes in cerebral blood flow from the acute to the chronic phase of severe head injury. J Neurotrauma 2005; 22:1411-1418.
13. Ueda T, Yuh WT. Single-photon emission CT imaging in acute stroke. Neuroimaging Clin N Am 2005; 15:543-551; x. Review of the use of SPECT following acute stroke.
14. Munari M, Zucchetta P, Carollo C, et al. Confirmatory tests in the diagnosis of brain death: comparison between SPECT and contrast angiography. Crit Care Med 2005; 33:2068-2073.
15. Baron JC, Frackowiak RS, Herholz K, et al. Use of PET methods for measurement of cerebral energy metabolism and hemodynamics in cerebrovascular disease. J Cereb Blood Flow Metab 1989; 9:723-742.
16. Derdeyn CP. Positron emission tomography imaging of cerebral ischemia. Neuroimaging Clin N Am 2005; 15:341-350; x-xi. Review of how PET imaging has advanced our understanding of cerebrovascular pathophysiology.
17. Jost SC, Diringer MN, Zazulia AR, et al. Effect of normal saline bolus on cerebral blood flow in regions with low baseline flow in patients with vasospasm following subarachnoid hemorrhage. J Neurosurg 2005; 103:25-30.
18. Johnston AJ, Steiner LA, Coles JP, et al. Effect of cerebral perfusion pressure augmentation on regional oxygenation and metabolism after head injury. Crit Care Med 2005; 33:189-195; discussion 255-257.
19. O'Connell MT, Seal A, Nortje J, et al. Glucose metabolism in traumatic brain injury: a combined microdialysis and [18F]-2-fluoro-2-deoxy-D-glucose- positron emission tomography (FDG-PET) study. Acta Neurochir Suppl 2005; 95:165-168.
20. Vespa P, Bergsneider M, Hattori N, et al. Metabolic crisis without brain ischemia is common after traumatic brain injury: a combined microdialysis and positron emission tomography study. J Cereb Blood Flow Metab 2005; 25:763-774. An important study, combining microdialysis and PET imaging, which demonstrates that mechanisms of neuronal injury following head injury are complex and require correlative analyses.
21. Silverman DH, Alavi A. PET imaging in the assessment of normal and impaired cognitive function. Radiol Clin North Am 2005; 43:67-77; x.
22. Owen AM, Coleman MR, Menon DK, et al. Residual auditory function in persistent vegetative state: a combined PET and fMRI study. Neuropsychol Rehabil 2005; 15:290-306. Important study that demonstrates the potential of functional neuroimaging in defining residual cognitive function in patients with a clinical syndrome consistent with a persistent vegetative state.
23. Pickard JD, Hutchinson PJ, Coles JP, et al. Imaging of cerebral blood flow and metabolism in brain injury in the ICU. Acta Neurochir Suppl 2005; 95:459-464.
24. Cunningham AS, Salvador R, Coles JP, et al. Physiological thresholds for irreversible tissue damage in contusional regions following traumatic brain injury. Brain 2005; 128 (Pt 8):1931-1942. An attempt to define the consequences of early derangements in blood flow and metabolism following head injury which demonstrates that it is difficult to predict tissue outcome using defined thresholds.
25. Bandera E, Botteri M, Minelli C, et al. Cerebral blood flow threshold of ischemic penumbra and infarct core in acute ischemic stroke: a systematic review. Stroke 2006; 37:1334-1339. Important review which highlights that further evaluation is required before ischaemic thresholds defined using perfusion imaging techniques can be used to direct patient therapy.
26. Yamauchi H, Kudoh T, Kishibe Y, et al. Selective neuronal damage and borderzone infarction in carotid artery occlusive disease: a 11C-flumazenil PET study. J Nucl Med 2005; 46:1973-1979.
27. Calamante F, Thomas DL, Pell GS, et al. Measuring cerebral blood flow using magnetic resonance imaging techniques. J Cereb Blood Flow Metab 1999; 19:701-735.
28. Kimura H, Kado H, Koshimoto Y, et al. Multislice continuous arterial spin-labeled perfusion MRI in patients with chronic occlusive cerebrovascular disease: a correlative study with CO2 PET validation. J Magn Reson Imaging 2005; 22:189-198.
29. Hendrikse J, van der Zwan A, Ramos LM, et al. Altered flow territories after extracranial-intracranial bypass surgery. Neurosurgery 2005; 57:486-494; discussion 486-494.
30. Ewing JR, Cao Y, Knight RA, Fenstermacher JD. Arterial spin labeling: validity testing and comparison studies. J Magn Reson Imaging 2005; 22:737-740.
31. Meier P, Zierler KL. On the theory of the indicator-dilution method for measurement of blood flow and volume. J Appl Physiol 1954; 6:731-744.
32. Zierler KL. Theoretical basis of indicator-dilution methods for measuring flow and volume. Circ Res 1962; 10:393-407.
33. Miles KA. Brain perfusion: computed tomography applications. Neuroradiology 2004; 46 (Suppl 2):s194-s200.
34. Scharf J, Brockmann MA, Daffertshofer M, et al. Improvement of sensitivity and interrater reliability to detect acute stroke by dynamic perfusion computed tomography and computed tomography angiography. J Comput Assist Tomogr 2006; 30:105-110.
35. Wintermark M, Fischbein NJ, Smith WS, et al. Accuracy of dynamic perfusion CT with deconvolution in detecting acute hemispheric stroke. AJNR Am J Neuroradiol 2005; 26:104-112.
36. Schaefer PW, Roccatagliata L, Ledezma C, et al. First-pass quantitative CT perfusion identifies thresholds for salvageable penumbra in acute stroke patients treated with intra-arterial therapy. AJNR Am J Neuroradiol 2006; 27:20-25.
37. Parsons MW, Pepper EM, Chan V, et al. Perfusion computed tomography: prediction of final infarct extent and stroke outcome. Ann Neurol 2005; 58:672-679. Demonstration of the utility of perfusion CT following acute stroke.
38. Baumgartner C, Gautsch K, Bohm C, Felber S. Functional cluster analysis of CT perfusion maps: a new tool for diagnosis of acute stroke? J Digit Imaging 2005; 18:219-226.
39. Hemphill JC 3rd, Smith WS, Sonne DC, et al. Relationship between brain tissue oxygen tension and CT perfusion: feasibility and initial results. AJNR Am J Neuroradiol 2005; 26:1095-1100.
40. Wintermark M, Ko NU, Smith WS, et al. Vasospasm after subarachnoid hemorrhage: utility of perfusion CT and CT angiography on diagnosis and management. AJNR Am J Neuroradiol 2006; 27:26-34.
41. Harrigan MR, Leonardo J, Gibbons KJ, et al. CT perfusion cerebral blood flow imaging in neurological critical care. Neurocrit Care 2005; 2:352-366. Review of CT perfusion and its use within a neurocritical care setting.
42. Nabavi DG, Cenic A, Craen RA, et al. CT assessment of cerebral perfusion: experimental validation and initial clinical experience. Radiology 1999; 213:141-149.
43. Gomori JM, Cohen JE. Imaging of cerebral perfusion in acute stroke. Neurol Res 2005; 27 (Suppl 1):S50-S52.
44. Gillard JH, Minhas PS, Hayball MP, et al. Assessment of quantitative computed tomographic cerebral perfusion imaging with H2(15)O positron emission tomography. Neurol Res 2000; 22:457-464.
45. Koenig M, Klotz E, Luka B, et al. Perfusion CT of the brain: diagnostic approach for early detection of ischemic stroke. Radiology 1998; 209:85-93.
46. Moseley ME, Kucharczyk J, Mintorovitch J, et al. Diffusion-weighted MR imaging of acute stroke: correlation with T2-weighted and magnetic susceptibility-enhanced MR imaging in cats. AJNR Am J Neuroradiol 1990; 11:423-429.
47. Busza AL, Allen KL, King MD, et al. Diffusion-weighted imaging studies of cerebral ischemia in gerbils: potential relevance to energy failure. Stroke 1992; 23:1602-1612.
48. Seitz RJ, Meisel S, Weller P, et al. Initial ischemic event: perfusion-weighted MR imaging and apparent diffusion coefficient for stroke evolution. Radiology 2005; 237:1020-1028.
49. Davis SM, Donnan GA, Butcher KS, Parsons M. Selection of thrombolytic therapy beyond 3 h using magnetic resonance imaging. Curr Opin Neurol 2005; 18:47-52. Review of the use of perfusion and diffusion MRI following ischaemic stroke in defining the ischaemic penumbra.
50. Barber PA, Hill MD, Eliasziw M, et al. Imaging of the brain in acute ischaemic stroke: comparison of computed tomography and magnetic resonance diffusion-weighted imaging. J Neurol Neurosurg Psychiatry 2005; 76:1528-1533.
51. Sobesky J, Zaro Weber O, Lehnhardt FG, et al. Does the mismatch match the penumbra? Magnetic resonance imaging and positron emission tomography in early ischemic stroke. Stroke 2005; 36:980-985. An important study that attempts to characterize the physiology of perfusion and diffusion-weighted MRI abnormalities following acute ischaemia.
52. Guadagno JV, Warburton EA, Jones PS, et al. The diffusion-weighted lesion in acute stroke: heterogeneous patterns of flow/metabolism uncoupling as assessed by quantitative positron emission tomography. Cerebrovasc Dis 2005; 19:239-246.
53. Shimosegawa E, Hatazawa J, Ibaraki M, et al. Metabolic penumbra of acute brain infarction: a correlation with infarct growth. Ann Neurol 2005; 57:495-504.
54. Rivers CS, Wardlaw JM, Armitage PA, et al. Do acute diffusion- and perfusionweighted MRI lesions identify final infarct volume in ischemic stroke? Stroke 2006; 37:98-104. This study highlights the difficulty of using MR parameters to define tissue outcome, and shows that tissue without evidence of a so-called perfusion diffusion mismatch is also at risk of infarction.
55. Kucinski T, Naumann D, Knab R, et al. Tissue at risk is overestimated in perfusion-weighted imaging: MR imaging in acute stroke patients without vessel recanalization. AJNR Am J Neuroradiol 2005; 26:815-819.
56. Schellinger PD, Latour LL, Wu CS, et al. The association between neurological deficit in acute ischemic stroke and mean transit time Comparison of four different perfusion MRI algorithms. Neuroradiology 2006; 48:69-77.
57. Butcher KS, Parsons M, MacGregor L, et al. Refining the perfusion-diffusion mismatch hypothesis. Stroke 2005; 36:1153-1159.
58. Perkio J, Soinne L, Ostergaard L, et al. Abnormal intravoxel cerebral blood flow heterogeneity in human ischemic stroke determined by dynamic susceptibility contrast magnetic resonance imaging. Stroke 2005; 36:44-49.
59. The Association of Anaesthetists of Great Britain and Ireland. Provision of anaesthetic services in magnetic resonance units, 2002.
60. Seitz RJ, Meisel S, Moll M, et al. Partial rescue of the perfusion deficit area by thrombolysis. J Magn Reson Imaging 2005; 22:199-205.
61. Chalela JA, Dunn B, Todd JW, Warach S. Induced hypertension improves cerebral blood flow in acute ischemic stroke. Neurology 2005; 64:1979.
62. Karapanayiotides T, Meuli R, Devuyst G, et al. Postcarotid endarterectomy hyperperfusion or reperfusion syndrome. Stroke 2005; 36:21-26.
63. Inglese M, Makani S, Johnson G, et al. Diffuse axonal injury in mild traumatic brain injury: a diffusion tensor imaging study. J Neurosurg 2005; 103:298-303.
64. Salmond CH, Menon DK, Chatfield DA, et al. Diffusion tensor imaging in chronic head injury survivors: correlations with learning and memory indices. Neuroimage 2006; 29:117-124.
65. Schaefer PW, Huisman TA, Sorensen AG, et al. Diffusion-weighted MR imaging in closed head injury: high correlation with initial glasgow coma scale score and score on modified Rankin scale at discharge. Radiology 2004; 233:58-66.
66. Kinoshita T, Moritani T, Hiwatashi A, et al. Conspicuity of diffuse axonal injury lesions on diffusion-weighted MR imaging. Eur J Radiol 2005; 56:5-11.
67. Barker PB. Fundamentals of MR spectroscopy. In: Gillard JH, Waldman AD, Barker PB, editors. Clinical MR Neuroimaging. Cambridge: Cambridge University Press; 2005. pp. 7-26.
68. Stengel A, Neumann-Haefelin T, Singer OC, et al. Multiple spin-echo spectroscopic imaging for rapid quantitative assessment of N-acetylaspartate and lactate in acute stroke. Magn Reson Med 2004; 52:228-238.
69. Hunter JV, Thornton RJ, Wang ZJ, et al. Late proton MR spectroscopy in children after traumatic brain injury: correlation with cognitive outcomes. AJNR Am J Neuroradiol 2005; 26:482-488.
70. Marmarou A, Signoretti S, Fatouros P, et al. Mitochondrial injury measured by proton magnetic resonance spectroscopy in severe head trauma patients. Acta Neurochir Suppl 2005; 95:149-151. An interesting study that demonstrates that neuronal injury as defined by a reduction in NAA takes several days to develop. Recovery of NAA is consistent with reversible mitochondrial impairment, while sustained reductions are predictive of poor outcome.
71. Belli A, Sen J, Petzold A, et al. Extracellular N-acetylaspartate depletion in traumatic brain injury. J Neurochem 2006; 96:861-869.
72. Saunders DE. MR spectroscopy in stroke. Br Med Bull 2000; 56:334-345.
73. Shutter L, Tong KA, Holshouser BA. Proton MRS in acute traumatic brain injury: role for glutamate/glutamine and choline for outcome prediction. J Neurotrauma 2004; 21:1693-1705.
74. Ashwal S, Holshouser B, Tong K, et al. Proton MR spectroscopy detected glutamate/glutamine is increased in children with traumatic brain injury. J Neurotrauma 2004; 21:1539-1552.
75. Liu YJ, Chen CY, Chung HW, et al. Neuronal damage after ischemic injury in the middle cerebral arterial territory: deep watershed versus territorial infarction at MR perfusion and spectroscopic imaging. Radiology 2003; 229:366-374.
76. Parsons MW, Li T, Barber PA, et al. Combined (1)H MR spectroscopy and diffusion-weighted MRI improves the prediction of stroke outcome. Neurology 2000; 55:498-505.
77. Pereira AC, Saunders DE, Doyle VL, et al. Measurement of initial N-acetyl aspartate concentration by magnetic resonance spectroscopy and initial infarct volume by MRI predicts outcome in patients with middle cerebral artery territory infarction. Stroke 1999; 30:1577-1582.
78. Holshouser BA, Tong KA, Ashwal S. Proton MR spectroscopic imaging depicts diffuse axonal injury in children with traumatic brain injury. AJNR Am J Neuroradiol 2005; 26:1276-1285.
79. Brooks WM, Friedman SD,Gasparovic C. Magnetic resonance spectroscopy in traumatic brain injury. J Head Trauma Rehabil 2001; 16:149-164.
80. Garnett MR, Cadoux-Hudson TA, Styles P. How useful is magnetic resonance imaging in predicting severity and outcome in traumatic brain injury? Curr Opin Neurol 2001; 14:753-757.
81. Welch KM, Levine SR, Martin G, et al. Magnetic resonance spectroscopy in cerebral ischemia. Neurol Clin 1992; 10:1-29.
82. Fisher M, Prichard JW, Warach S. New magnetic resonance techniques for acute ischemic stroke. JAMA 1995; 274:908-911.