Neuronal Damage after Ischemic Injury in the Middle Cerebral Arterial Territory: Deep Watershed versus Territorial Infarction at MR Perfusion and Spectroscopic Imaging

Yi Jui Liu, Cheng Yu Chen, Hsiao Wen Chung, Ing Jye Huang, Chang Shin Lee, Shy Chyi Chin, Michelle Liou

研究成果: 雜誌貢獻文章同行評審

17 引文 斯高帕斯(Scopus)

摘要

PURPOSE: To determine the temporal patterns of neuronal injury between infarction subtypes and their possible association with changes in cerebral blood volume (CBV). MATERIALS AND METHODS: Twenty-five patients with ischemic injuries of middle cerebral arterial territories and receiving only conservative treatments were classified into territorial infarction (TI) (n = 16) and watershed infarction (WI) (n = 9) groups and were prospectively evaluated with longitudinal magnetic resonance (MR) examinations. Each patient underwent as many as five MR studies at various stroke stages following stroke symptom onset. Dynamic susceptibility-weighted contrast material-enhanced MR imaging was performed to yield the relative CBV (rCBV). Chemical shift imaging was used to measure the relative levels of N-acetylaspartate (NAA) and lactate of the ischemic brain tissue. Repeated-measures analysis of variance was used to examine the statistical significance in evolutional differences between TI and WI. RESULTS: For patients with TI, rCBV followed a progressively increasing pattern, from initial low values (0.46 ± 0.28 [SD]) to peak high values (1.23 ± 0.34) at early chronic stage. Relative NAA level decreased to 0.40 ± 0.24 during acute stroke and was lost completely 4 days after ictus. Patients with WI showed consistently high rCBV throughout all stages, with residual relative NAA level (0.53 ± 0.25) even at 1 month after symptom onset. Relative lactate level of patients with TI was significantly higher than that of patients with WI at the acute stage (P <.01). Differences in the temporal changes of both rCBV and brain metabolites between TI and WI were significant (P <.01). CONCLUSION: The different temporal patterns for stroke progression in TI and WI are associated with different evolutions of hemodynamics and neuronal injury.
原文英語
頁(從 - 到)366-374
頁數9
期刊Radiology
229
發行號2
DOIs
出版狀態已發佈 - 十一月 2003
對外發佈

ASJC Scopus subject areas

  • 放射與超音波技術

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