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

In this review, the clinical utility of echoplanar techniques in MRI of the brain is discussed. Comparison of high-resolution EPI with SE/turbo-SE shows high image quality of EPI in the supratentorial brain. In the infratentorial region, however, susceptibility artifacts limit image quality. For the assessment of neuronal brain activation utilizing the intrinsic contrast of blood (BOLD), EPI has definite advantages over other techniques of functional MRI. Due to its superior temporal resolution and multislice capabilities, EPI allows for analysis of complex neuronal activation patterns. Diffusion imaging benefits from the lack of bulk motion artifacts and serves primarily to detect early stroke. Three methods of perfusion imaging (rel. blood volume, rel. blood flow) are discussed: the susceptibility artifact method (T2*), the relaxitivity method (T1), and the signal-labelling technique (STAR). Perfusion imaging may have a clinical impact in the assessment of brain tumors and cerebral ischemia.
 ...
PMID:[Echo-planar imaging of the brain]. 858 33

Rapid changes in the apparent diffusion coefficient of water following brain ischemia have been extensively studied using echo planar diffusion imaging at low fields (2.0 T). There is a desire to perform these studies at higher fields (> 3.0 T) where the benefits of improved signal-to-noise can be exploited. Unfortunately, EPI diffusion is technically difficult to implement at high fields because of large magnetic susceptibility effects. This article demonstrates the feasibility of employing a line-scan diffusion protocol for ADCw measurements in stroke. The technique was applied on a 4.0 T system to monitor the decline in ADCw following the induction of focal cerebral ischemia in rat. ADCw data were acquired every 15 s with 10 b-values or every 22.5 s with 15 b-values, with a cubic spatial resolution of 1.5 mm. The results demonstrate that estimates of ADCw can be acquired with coefficients of variation under 3.0%, and with a combination of spatial and temporal resolution comparable to that previously reported for EPI.
 ...
PMID:The application of diffusion-weighted line-scanning for the rapid assessment of water ADC changes in stroke at high magnetic fields. 926 65

We compared gradient-echo (GRE), spin-echo (SE) and stimulated-echo (STE) echo-planar imaging sequences for perfusion-weighted imaging at different field strengths. Focal cerebral ischaemia was induced by endovascular occlusion of the middle cerebral artery in eight rats. MR was performed at 4.7 T or 2.35 T. With each sequence, we acquired data sets before, during and after bolus injection of Gd-DTPA with a time resolution of 1.2 s per image. The perfusion-weighted images were assessed with regard to image quality, artefacts, signal-to-noise ratio (SNR), and signal-at-tenuation-to-noise ratio (delta SNR) of the non-ischaemic tissue. Visual assessment showed GRE-EPI images acquired at 4.7 T to suffer from distortion due to susceptibility artefacts. Artefacts were less marked with the SE and STE series. The GRE-EPI sequence gave the highest SNR and delta SNR. At 2.35 T, the SNR of the STE sequences was less than 3 and therefore did not allow construction of reliable signal-time curves. SE-EPI was best suited for perfusion-weighted imaging at high field strength thanks to its minimal distortion artefacts and high SNR. Using lower field strengths (2.35 T and less), susceptibility artefacts are reduced; GRE-EPI sequences are then best suited, because they have the highest SNR and T2* sensitivity.
 ...
PMID:Comparison of echo-planar sequences for perfusion-weighted MRI: which is best? 959 90

Diffusion-weighted (DWI) echo-planar (EPI) MRI has been used for imaging acute ischaemic stroke. We used DWI and conventional spin-echo (SE) MRI to study the dynamics of ischaemic human stroke. We examined 30 patients (mean age 57.5 years, range 27-82 years, median 57 years) with a diagnosis of stroke. They were examined in the acute (120 min to 47 h, mean 15.3 h), subacute (8 days) and chronic (2-3 months) stages of ischaemia using clinical scores and MRI. Imaging was performed on an 1.5-T imager. Anisotropic DWI with diffusion gradients in all three axes, an isotropic tensor trace pulse DWI sequence and SE MRI were used. In all patients both DWI sequences showed a decrease in the apparent diffusion coefficient (ADC) in the acute stage, even when SE images did not reveal signal abnormalities. Clinical features correlated with lesion site but not size. The ADC was initially 19.6-43% less than that of nonischaemic tissue and increased to normal after 7 days in conventionally treated patients and after 2-5 days in patients who underwent intra-arterial fibrinolysis. In the chronic stage the ADC rose by up to 254.4 %. In patients who did not undergo fibrinolysis DWI changes correlated with the final infarct size (P<0.05). It was possible to differentiate acute from chronic ischaemic lesions. We conclude that DWI is a sensitive and practicable tool for detecting early cerebral ischaemia. It is possible to predict in the acute stage the final size of an infarct. DWI may be helpful for clinical decisions and for monitoring therapy.
 ...
PMID:Diffusion-weighted imaging in ischaemic stroke: a follow-up study. 1077 39

We used a rat model of focal cerebral ischaemia to compare stimulated-echo (STE) and spin-echo (SE) echo planar (EPI) diffusion-weighted sequences as regards image quality and accuracy of calculation of apparent diffusion coefficients (ADC). Focal cerebral ischaemia was induced by endovascular occlusion of the middle cerebral artery in five rats. MRI was performed on a 2.35 tesla imager. For diffusion-weighted imaging (DWI) we used STE-EPI and SE-EPI with different diffusion times (delta) of 15, 30, 45, 60, 75 and 90 ms using values of b of 200, 300, 400, 500, 600 and 700 s/mm2. We assessed image quality, the signal-to-noise-ratio (SNR) and the accuracy of the ADC calculated from both sequences. Infarcts were delineated in all cases, independent of sequence type and delta. The image quality and SNR of the SE-EPI images were significantly better, with a higher SNR than STE-EPI images for short and intermediate values of delta. However, when delta reached 75 ms STE-EPI became superior to SE-EPI. ADC calculated from STE-EPI images were smaller than those from SE-EPI images for short and intermediate diffusion times, possibly because of the lower SNR of the former. We suggest that SE-EPI sequences be used for DWI of the brain, particularly on experimental systems and whole-body imagers with enhanced gradient hardware, where it is possible to run highly diffusion-weighted sequences (b > 500 s/mm2) with delta less than 50 ms. However, when using very long values of delta because of hardware restrictions or for measurement of restricted diffusion, STE sequences give better results.
 ...
PMID:Diffusion-weighted imaging of the brain: comparison of stimulated- and spin-echo echo-planar sequences. 1146 54

Infarction is a rare cause of spinal cord dysfunction. Whereas diffusion-weighted (DW) MRI has been established as a highly sensitive technique for assessing acute cerebral ischemia, its role in spinal cord infarction remains to be determined. The purpose of this study is to present the signal characteristics of acute spinal cord ischemia using DWMRI within the first two days and after one week. MRI including DW imaging (DWI) was performed in three patients with acute spinal cord dysfunction 8, 12 and 30 hours after the onset of symptoms and repeated after one week in two patients. Two initial scans included EPI DW sequences in transverse and sagittal orientation. The remaining examinations were performed with an optimised high-spatial resolution DWI sequence in the transverse plane. The diagnosis of spinal cord ischemia was established by imaging, clinical history and CSF analysis. T2 signal abnormality and restricted diffusion was demonstrated in all initial examinations. Transverse DW sequences had the highest sensitivity. The spinal infarctions were mainly located in the centre of the spinal cord and the grey matter. Contrast enhancement was absent. After one week, the restricted diffusion had normalised (pseudo normalisation) whereas the T2 signal changes had become more prominent. Restricted diffusion in the course of spinal cord ischemic infarction can be demonstrated using DW-MRI. Whereas a diffusion abnormality can be found after few hours, it does not last for longer than one week. At this time, the establishment of the diagnosis has to rely mainly on T2-weighted images with additional post contrast T1-weighted images being useful.
 ...
PMID:Diffusion-weighted MRI of spinal cord infarction--high resolution imaging and time course of diffusion abnormality. 1525 83

Danhong injection (DHI) is a Chinese Material Medical standardized traditional Chinese medicine injection (TCMI) used for the treatment of coronary heart disease and cerebral ischemia. The present study aims to describe and exemplify an UPLC-QTrap based integrated strategy enhanced by precursor ion (PRE) scan, to systematically and rapidly identify the chemical constituents of DHI. After untargeted EMS-IDA-EPI scan, fragmentation study of representative components and focused PRE scans, 90 compounds were tentatively identified. Compared with the single full scan, the presented strategy provided high sensitivity to phenolic compounds with the help of PRE scan mode and QqQ instrument. Considering the abundant phenolic contents in DHI, the established strategy was designed to give sensitive and systematic characterization of phenolic constituents. The results may provide more information to help illustrate the relationship between the complicated constituents and the therapeutic effects of DHI. This strategy may also be applied in researches on other traditional Chinese medicine products.
 ...
PMID:Precursor ion scan enhanced rapid identification of the chemical constituents of Danhong injection by liquid chromatography-tandem mass spectrometry: An integrated strategy. 3104 29