A novel method to derive separate gray and white matter cerebral blood flow measures from MR imaging of acute ischemic stroke patients

Jessica E. Simon, Michael S. Bristow, Hong Lu, M. Louis Lauzon, Robert A. Brown, José V. Manjón, Michael Eliasziw, Richard Frayne, Alastair M. Buchan, Andrew M. Demchuk, J. Ross Mitchell

Research output: Contribution to journalArticle

23 Scopus citations

Abstract

Perfusion-weighted imaging (PWI) measures can predict tissue outcome in acute ischemic stroke. Accuracy might be improved if differential tissue susceptibility to ischemia is considered. We present a novel voxel-by-voxel analysis to characterize cerebral blood flow (CBF) separately in gray (GM) and white matter (WM). Ten patients were scanned with inversion-recovery spin-echo EPI (IRSEPI), diffusion-weighted imaging (DWI), PWI <6h from onset and fluid attenuated inversion-recovery (FLAIR) at 30 days. Image processing included coregistration to PWI, automatic segmentation of IRSEPI into GM, WM and CSF and semiautomatic segmentation of DWI/FLAIR to derive the acute and 30-day lesions. Five tissue compartments were defined: (1) 'Core' (abnormal acutely and at 30 days), (2) 'Growth' (or 'infarcted penumbra', abnormal only at 30 days), (3) 'Reversed' (abnormal acutely but normal at 30 days), (4) 'MTT-Delayed' (tissue with delayed mean transit time but not part of the acute or 30-day lesion), and (5) 'Normal' brain. Cerebral blood flow in GM and WM of each compartment was obtained from quantitative maps. Gray matter and WM mean CBF in the growth region differed by 5.5mL/100gmin (P = 0.015). Mean CBF also differed significantly within normal and MTT-Delayed compartments. The difference in the reversed region approached statistical significance. In core, GM and WM CBF did not differ. The results suggest separate ischemic thresholds for GM and WM in stroke penumbra.

Original languageEnglish (US)
Pages (from-to)1236-1243
Number of pages8
JournalJournal of Cerebral Blood Flow and Metabolism
Volume25
Issue number9
DOIs
StatePublished - 2005

Keywords

  • Cerebral blood flow
  • Gray and white matter
  • MRI
  • Stroke

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology
  • Cardiology and Cardiovascular Medicine

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