Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0917798 (cerebral ischemia)
 17,036 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Magnetic resonance diffusion-weighted imaging (MR-DWI) is sensitive to the diffusibility of water and may offer characterization and anatomical localization of stroke leading to early tailored therapeutic intervention. We compared DWI, the apparent diffusion constant (ADC), and autoradiographic cerebral blood flow (CBF) in a model of focal cerebral ischemia in the rat. Sprague-Dawley rats were embolized with a single silicone cylinder injected into the internal carotid artery. Both common carotids were permanently ligated. The animals were anesthetized (isoflurane in O2), and paralyzed (gallamine). MR-DWI were obtained with a GE 4.7 T magnet (TE = 3 s, TR = 80 msec, b = 2393.10(-3) mm2/s, slice thickness 3 mm). DWI and CBF autoradiograms were compared visually. ADC was assessed in various regions, including ischemic cortex and a region homologous to ischemic cortex. Imaging times from stroke onset were 50 +/- 6 min (mean +/- SEM) for DWI, 185 +/- 17 min for a second DWI. CBF was determined at 258 +/- 15 min. The specificity was 100% at both 50 min and 185 min, indicating that there were no false positives; in 3 animals ischemia was not present. However, the sensitivity analysis indicated that early DWI yields some false negatives; at 50 min the sensitivity was 60%. We attribute our result of low early sensitivity to small infarcts in relation to the slice thickness. Later, at 185 min, sensitivity was 100%. The first ADCs were higher than the second ADC values in ischemic cortex. For infarcts larger than the slice thickness, early MR-DWI is highly sensitive for imaging evolving ischemia.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Magnetic resonance diffusion-weighted imaging: sensitivity and apparent diffusion constant in stroke. 797 48

Diffusion-weighted MRI has been used to investigate therapeutic intervention with MK-801 in an animal model of permanent focal cerebral ischaemia. The animals were imaged continuously for 4 h and again at 24 h following occlusion of the middle cerebral artery (MCA) allowing the development of the ischaemic lesion to be monitored continuously in the same animals. An increased DWI signal, seen as a region of hyperintensity, was detected 1 h after MCA-occlusion in the lateral cortex and caudate nucleus in both control and MK-801 (administered at a dose of 3 mg/kg i.p. 5 min post-ischaemia) treated animals. However, the volume of hemispheric and cortical hyperintensity was smaller in the MK-801-treated animals. The area of hyperintensity progressively increased in the control group over the 4 h imaging time and there was also an increase in the area of hyperintensity between 4 and 24 h. At these time points the area of hyperintensity encompassed the dorsolateral cortex and caudate nucleus. MK-801 treated animals also demonstrated some progressive increase in the area of hyperintensity between 1 and 3 h, but no significant increase in the area of hyperintensity was seen after this time. The hyperintense regions at 4 and 24 h were restricted to the so-called 'core areas' of the lesion in MK-801-treated animals. Thus, using DWI the tissue 'at risk' following ischaemia could be identified and the protective effect of therapeutic intervention demonstrated.
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PMID:The protective effect of MK-801 on infarct development over a period of 24 h as assessed by diffusion-weighted magnetic resonance imaging. 907 2

The effect of anti-intercellular adhesion molecule-1 (anti-ICAM-1) antibody treatment of transient (2 h) middle cerebral artery (MCA) occlusion in the rat was measured using diffusion (DWI)-, T2 (T2I)- and perfusion (PWI)-weighted magnetic resonance imaging. Rats were treated upon reperfusion with an anti-ICAM-1 monoclonal antibody (n=11) or a control antibody (n=7). DWI, T2I and PWI were performed before, during, and after induction of focal cerebral ischemia from 1 h to 7 days. In both groups, the apparent diffusion coefficient of water (ADCw) and cerebral blood flow (CBF) values in the ischemic region significantly declined from the preischemic ADCw values (p<0. 05). The post ischemic increase in T2 of the control group was significantly higher at 48 h than in the anti-ICAM-1 treated group (p<0.05). CBF was not significantly different between the two groups. The temporal profiles of MRI cluster analysis, which combines ADCw and T2 maps into a single image, was significantly different between groups. These data suggest that the neuroprotective effect of anti-ICAM-1 antibody treatment is reflected in reductions of T2 and lesion growth during reperfusion and may not be associated with increased cerebral perfusion.
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PMID:Diffusion, perfusion, and T2 magnetic resonance imaging of anti-intercellular adhesion molecule 1 antibody treatment of transient middle cerebral artery occlusion in rat. 955 9

Combined NMR imaging and spectroscopy have been applied to mouse brain during focal cerebral ischemia. The present study evaluated the feasibility of NMR measurements on mice in order to fine-tune the sequences and experimental setup for systematic investigations on stroke including future studies on transgenic animals. The acquisition of high quality diffusion-weighted, perfusion-weighted, and T2-weighted images (DWI, PWI, T2-WI, respectively) is demonstrated and complemented by measurements of 1H volume-selective spectroscopy and spectroscopic imaging (SI). Despite the small volume of the mouse brain, a satisfactory signal-to-noise ratio can be achieved with reasonably short measurement times. C57black/6J mice with an average body weight of 25 g were studied using state-of-the-art NMR sequences at 4.7 T. After induction of focal cerebral ischemia, the lesion was found clearly distinguishable in all imaging techniques. The apparent diffusion coefficient (ADC) was reduced in the ischemic region, and an expansion of the affected volume was observed with ongoing ischemia time. In the H spectra of ischemic animals a distinct change in the concentrations of NAA and lactate was visible. This is the first report on both SI data and perfusion-weighted imaging on mouse brain. It is demonstrated that the perfusion deficit during ischemia can be well demarcated. The spatial resolution of changes in metabolite concentrations allows the clear differentiation of elevated lactate levels in ischemic brain tissue.
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PMID:High resolution MRI and MRS: a feasibility study for the investigation of focal cerebral ischemia in mice. 1022 85

Diffusion-weighted magnetic resonance imaging was performed to determine the detectability of ischemic changes in patients with ischemic cerebrovascular disease. We retrospectively reviewed 103 patients with symptoms suggestive of ischemic cerebrovascular disease. All patients underwent computed tomography, routine magnetic resonance imaging, and diffusion-weighted imaging. Of 103 patients, 18 were imaged within 3 hours after onset, 57 were imaged between 3 and 24 hours, and 29 were imaged between 24 and 144 hours. Eighty-eight patients were diagnosed as ischemic cerebrovascular disease. Magnetic resonance imaging was performed at a 1.0 Tesla clinical machine using single-shot spin-echo/echo-planar imaging sequence. In each case, three sets of DWI with motion-probing gradient pulses in the x, y, and z directions were taken. The detectability of ischemic changes of each imaging modality was compared. DWI detected ischemic changes in 83 of 88 cases with clinical diagnoses of cerebral ischemia(sensitivity; 94.3%). In contrast, DWI showed negative findings in 15 of the 15 patients with diagnoses other than cerebral ischemia(selectivity; 100.0%). DWI detected ischemic changes in 16 out of 18 patients(88.6%) within 3 hours after the onset. In contrast, T 2-weighted image did not detect any ischemic changes in the same period. These results suggest that DWI is considered to be highly useful for the early diagnosis of cerebral ischemia.
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PMID:[Clinical usefulness of diffusion-weighted magnetic resonance imaging in patients with ischemic cerebrovascular disease]. 1072 55

This study presents histological validation of an objective (unsupervised) computer segmentation algorithm, the iterative self-organizing data analysis technique (ISODATA), for analysis of multiparameter magnetic resonance imaging (MRI) data in experimental focal cerebral ischemia. T2-, T1-, and diffusion (DWI) weighted coronal images were acquired from 4 to 168 hours after stroke on separate groups of animals. Animals were killed immediately after MRI for histological analysis. MR images were coregistered/warped to histology. MRI lesion areas were defined using DWI, apparent diffusion coefficient (ADC) maps, T2-weighted images, and ISODATA. The last techniques clearly discriminated between ischemia-altered and morphologically intact tissue. ISODATA areas were congruent and significantly correlated (r = 0.99, P < 0.05) with histologically defined lesions. In contrast, DWI, ADC, and T2 lesion areas showed no significant correlation with histologically evaluated lesions until subacute time points. These data indicate that multiparameter ISODATA methodology can accurately detect and identify ischemic cell damage early and late after ischemia, with ISODATA outperforming ADC, DWI, and T2-weighted images in identification of ischemic lesions from 4 to 168 hours after stroke.
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PMID:Unsupervised segmentation of multiparameter MRI in experimental cerebral ischemia with comparison to T2, diffusion, and ADC MRI parameters and histopathological validation. 1076 72

The immunosuppressive drug FK506 (tacrolimus) has been reported to be a powerful neuroprotective agent in the focal ischemia of animals. However, no report has been published concerning neuroprotective effect of this compound on the morphology in superacute stage. The separate analysis between early and delayed effects of FK506 on the morphology may be helpful in the study of the compound's mechanism of action which is still unknown. The goal of this study was to determine early and delayed effects of pharmacological treatment with FK506 in permanent MCA occlusion using magnetic resonance imaging (MRI). Nineteen rats were subjected to permanent MCA occlusion, and given either intravenous injection of placebo or 1 mg/kg FK506 immediately after occlusion. DWI and T(2)-weighted MRI were performed 3 and 24 h after MCA occlusion, and postmortem histological analysis was also performed. FK506 drastically reduced the ischemic damage in 3-h apparent diffusion coefficient (ADC) map. This is the first report to demonstrate the neuroprotective effects of FK506 on focal cerebral ischemia in superacute stage. In addition, postmortem ischemic damage tended to be smaller than ischemic area indicated by 3-h ADC map in the FK506 group, whereas there was an excellent equality between them in the placebo group, suggesting the possible effect of FK506 on the later ischemic period. Our findings provide direct evidence for the neuroprotective effect of FK506 on ischemic cell damage in both early stage and possibly later stage.
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PMID:Early and delayed neuroprotective effects of FK506 on experimental focal ischemia quantitatively assessed by diffusion-weighted MRI. 1135 52

In industrialized nations, stroke is the most common cause of permanent disability and need of care. Causal treatment is possible only during the first few hours following the stroke, in the form of systemic fibrinolysis. An exact diagnosis of the causative pathology must be made before starting the therapy, and this must happen in the shortest possible period of time. Using imaging techniques, the whole spectrum of differential diagnoses of cerebral ischemia must be covered, including above all intracerebral and subarachnoid hemorrhage. Although computed tomography (CT) is excellently suited for determining hemorrhage, infarct can be recognized with much better contrast using diffusion-weighted magnetic resonance (MR) imaging (DWI). Stroke MR imaging additionally allows the representation of vital "tissue at risk" of infarction using perfusion images as well as the recognition of vessel occlusion using MR angiography. This paper is intended to define the usefulness of DWI in comparison to CT techniques and to elucidate the use of diffusion coefficients for differentiating the various stages of infarction. Besides presenting an explanation of the basic principles of modern stroke MR imaging, typical results of MR perfusion measurements and the appearance of hemorrhages on MR will be explained.
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PMID:[Modern nuclear magnetic resonance techniques in stroke]. 1197 86

Thrombolytic therapy with rt-PA given within 3 h after stroke onset to patients with ischemic stroke significantly improves outcome after stroke. There are some evidences that thrombolysis may also work up to 6 h after stroke onset in carefully identified patients, but the three most important trials, which used 0-6 h time-windows, combined with CT-scans to define the ischemic areas, failed individually to produce statistical benefits for the rt-PA-treated patients. In order to enlarge the time-window there is a need for additional information about the functionality of the affected brain area. There is a growing interest in the use of Diffusion Weighted (magnetic resonance) imaging (DWI) and Perfusion Weighted (magnetic resonance) imaging (PWI) in the assessment of patients with acute ischemic stroke. These magnetic resonance techniques are powerful methods for identifying the extent and location of early cerebral ischemia.
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PMID:The very acute stroke treatment: fibrinolysis and after. 1245 Feb 34

Atherosclerotic disease of the extracranial vessels is a frequent cause of cerebral ischemia and stroke. Many natural history studies and prospective treatment trials with large patient samples have focused on optimal patient assessment in regard to medical or interventional measures. Clinical decision making nowadays is largely based on the identification, visualization, and grading of the local stenosis, and the identification of neurologic symptoms related to carotid artery stenosis. MRI already has contributed considerably as many surgeons no longer require preoperative conventional contrast angiography but may use the combination of duplex ultrasound studies and MRA for visualization of the pathology. Besides MRA improvements, DWI and PWI are increasingly used in addition to conventional MR contrasts (PD, T2-, T1-weighted MRI) in attempts to gather information on tissue status and the pathophysiology of hemodynamic compromise and cerebral ischemia in patients with carotid artery stenosis. Obtaining background information using this array of MR data may eventually become a basis for optimal risk-benefit assessment in patients with carotid artery stenosis.
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PMID:Diffusion and perfusion MRI for the assessment of carotid atherosclerosis. 1248 27


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