Tsai Yuan-Hsiung, Yang Jenq-Lin, Lee I-Neng, Yang Jen-Tsung, Lin Leng-Chieh, Huang Yen-Chu, Yeh Mei-Yu, Weng Hsu-Huei, Su Chia-Hao
Departments of Diagnostic Radiology, Chang Gung Memorial Hospital, Chiayi, College of Medicine, Chang Gung University, Taoyuan, Taiwan.
Institute for Translational Research in Biomedicine, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan.
Front Neurol. 2018 Sep 20;9:786. doi: 10.3389/fneur.2018.00786. eCollection 2018.
Dehydration is common among ischemic stroke patients and is associated with early neurological deterioration and poor outcome. This study aimed to test the hypothesis that dehydration status is associated with decreased cerebral perfusion and aggravation of ischemic brain injury. Diffusion-weighted imaging and arterial spin labeling perfusion MR imaging were performed on rats with middle cerebral artery occlusion (MCAO) by using a 9.4T MR imaging scanner to measure the volume of infarction and relative cerebral blood flow (rCBF) after infarction. Twenty-five rats were assigned to either a dehydration group or normal hydration group, and dehydration status was achieved by water deprivation for 48 h prior to MCAO. The volume of the infarction was significantly larger for the dehydration group at the 4th h after MCAO ( = 0.040). The progression in the infarct volume between the 1st and 4th h was also larger in the dehydration group ( = 0.021). The average rCBF values of the contralateral normal hemispheres at the 1st and the 4th h were significantly lower in the dehydration group ( = 0.027 and 0.040, respectively). Our findings suggested that dehydration status is associated with the progression of infarct volume and decreases in cerebral blood flow during the acute stage of ischemic stroke. This preliminary study provided an imaging clue that more intensive hydration therapies and reperfusion strategies are necessary for the management of acute ischemic stroke patients with dehydration status.
脱水在缺血性中风患者中很常见,并且与早期神经功能恶化和不良预后相关。本研究旨在验证脱水状态与脑灌注减少及缺血性脑损伤加重相关这一假说。通过使用9.4T磁共振成像扫描仪,对大脑中动脉闭塞(MCAO)大鼠进行扩散加权成像和动脉自旋标记灌注磁共振成像,以测量梗死体积和梗死后相对脑血流量(rCBF)。将25只大鼠分为脱水组或正常水化组,在MCAO前48小时通过禁水实现脱水状态。MCAO后第4小时,脱水组的梗死体积显著更大(P = 0.040)。脱水组在第1小时和第4小时之间梗死体积的进展也更大(P = 0.021)。脱水组在第1小时和第4小时对侧正常半球的平均rCBF值显著更低(分别为P = 0.027和0.040)。我们的研究结果表明,脱水状态与缺血性中风急性期梗死体积的进展及脑血流量减少相关。这项初步研究提供了一个影像学线索,即对于有脱水状态的急性缺血性中风患者,更强化的水化治疗和再灌注策略是必要的。