Abstract:
BACKGROUND AND PURPOSE:In ischemic stroke, diffusion-weighted (DW) and perfusion-weighted (PW) magnet resonance imaging (MRI) is used to define the mismatch as the therapeutic target. With positron emission tomography (PET), we characterized the metabolic patterns of tissue compartments identified by MRI and compared the volumes of mismatch to those of PET-defined penumbra. METHODS:In 6 acute (median, 5.2 hours) and 7 chronic (median, 10 days) stroke patients in whom a mismatch was defined by PW/DW MRI, PET was performed (median, 120-minute delay). Cerebral blood flow (CBF), oxygen metabolism (CMRO2), and oxygen extraction fraction (OEF) was determined in the areas of DWI lesion, mismatch, and oligemia. Then, the mismatch volume was compared with the volume of penumbra. RESULTS:DWI lesions showed impaired tissue integrity (low CMRO2 and low OEF). Mismatch areas were viable (normal CMRO2) but showed largely varying OEF. Oligemic areas had metabolic patterns comparable to normal tissue. A mismatch volume was found in all 13 patients. However, only 8 of 13 had a corresponding penumbra volume that covered only a part of the mismatch. CONCLUSIONS:Our comparative PET/MRI study confirmed the current pathophysiological hypothesis for the DWI lesion and for the oligemic areas. However, the mismatch area did not reliably detect elevated OEF and overestimated the penumbra defined by PET.
journal_name
Strokejournal_title
Strokeauthors
Sobesky J,Zaro Weber O,Lehnhardt FG,Hesselmann V,Neveling M,Jacobs A,Heiss WDdoi
10.1161/01.STR.0000160751.79241.a3subject
Has Abstractpub_date
2005-05-01 00:00:00pages
980-5issue
5eissn
0039-2499issn
1524-4628pii
01.STR.0000160751.79241.a3journal_volume
36pub_type
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