ASSESSMENT OF REGIONAL CEREBRAL BLOOD-VOLUME IN ACUTE HUMAN STROKE BYUSE OF SINGLE-SLICE DYNAMIC SUSCEPTIBILITY CONTRAST-ENHANCED MAGNETIC-RESONANCE-IMAGING

Background and Purpose The purpose of this study was to evaluate the c linical usefulness of dynamic susceptibility contrast-enhanced MRI (DS C-MRI) in acute cerebral ischemia. Methods During bolus injection of g adolinium-diethylenetriamine pentaacetic acid, a series of rapid T-2- weighted images was recorded from one slice. Concentration-time curves and images of regional cerebral blood volume (rCBV) were calculated f rom this data set. DSC-MRI, MR angiography, conventional spin-echo MRI (SE-MRI), and CT were performed in 11 patients within 6 hours after s troke onset and before thrombolytic or anticoagulant treatment was beg un. A follow-up MRI examination was performed 24 to 48 hours after str oke onset. Results In 7 of 11 patients (group 1) with territorial infa rcts of the middle (n=6) or posterior cerebral artery (n=1), DSC-MRI s howed reduced rCBV in the affected territory before conventional SE-MR I displayed ischemic lesions. DSC-MRI was helpful to differentiate sev erely ischemic tissue from peri-infarct parenchyma. Partial reperfusio n (n=3), unchanged reduction of rCBV (n=2), and progressive reduction of rCBV (n=2) were observed in the follow-up study, Normal DSC-MRI fin dings were present in 4 of 11 patients (group 2) with lacunar infarcts . Conclusions DSC-MRI accomplished the detection of the ischemic terri tory in the very early stage (<6 hours) before SE-MRI delivered unequi vocal results. DSC-MRI might be helpful to discriminate: completely is chemic tissue from potentially salvageable ischemic parenchyma at risk and may play an important role in stroke therapy and evaluation.