Kettunen M I, Mäkelä H I, Penttonen M, Pitkänen A, Lukkarinen J A, Kauppinen R A
NMR Research Group, A.I. Virtanen Institute for Molecular Sciences, University of Kuopio, Finland.
J Cereb Blood Flow Metab. 2000 Oct;20(10):1457-66. doi: 10.1097/00004647-200010000-00007.
The impact of brain imaging on the assessment of tissue status is likely to increase with the advent of treatment methods for acute cerebral ischemia. Multimodal magnetic resonance imaging (MRI) demonstrates potential for selecting stroke therapy patients by identifying the presence of acute ischemia, delineating the perfusion defect, and excluding hemorrhage. Yet, the identification of tissue subject to reversible or irreversible ischemia has proven to be difficult. Here, the authors show that T1 relaxation time in the rotating frame, so-called T1rho, serves as a sensitive MRI indicator of cerebral ischemia in the rat. The T1rho prolongs within minutes after a drop in the CBF of less than 22 mL 100 g(-1) min(-1). Dependence of T1rho on spin-lock amplitude, termed as T1rho dispersion, increases by approximately 20% on middle cerebral artery (MCA) occlusion, comparable with the magnitude of diffusion reduction. The T1rho dispersion change dynamically increases to be 38% +/- 10% by the first 60 minutes of ischemia in the brain region destined to develop infarction. Following reperfusion after 45 minutes of MCA occlusion, the tissue with elevated T1rho dispersion (yet normal diffusion) develops severe histologically verified neuronal damage; thus, the former parameter unveils an irreversible condition earlier than currently available MRI methods. The T1rho dispersion as a novel MRI index of cerebral ischemia may be useful in determination of the therapeutic window for acute ischemic stroke.
随着急性脑缺血治疗方法的出现,脑成像对组织状态评估的影响可能会增加。多模态磁共振成像(MRI)通过识别急性缺血的存在、描绘灌注缺损和排除出血,显示出选择中风治疗患者的潜力。然而,已证明识别易发生可逆或不可逆缺血的组织很困难。在此,作者表明旋转坐标系中的T1弛豫时间,即所谓的T1rho,可作为大鼠脑缺血的敏感MRI指标。在脑血流量(CBF)降至低于22 mL·100 g⁻¹·min⁻¹后的几分钟内,T1rho会延长。T1rho对自旋锁定幅度的依赖性,即所谓的T1rho色散,在大脑中动脉(MCA)闭塞时增加约20%,与扩散减少的幅度相当。在注定会发生梗死的脑区,缺血最初60分钟内,T1rho色散变化动态增加至38%±10%。在MCA闭塞45分钟后再灌注,T1rho色散升高(但扩散正常)的组织会出现严重的经组织学证实的神经元损伤;因此,与目前可用的MRI方法相比,前一个参数能更早地揭示不可逆状态。T1rho色散作为一种新的脑缺血MRI指标,可能有助于确定急性缺血性中风的治疗窗。