Journal article
Identifying the ischaemic penumbra using pH-weighted magnetic resonance imaging.
- Abstract:
- The original concept of the ischaemic penumbra suggested imaging of regional cerebral blood flow and metabolism would be required to identify tissue that may benefit from intervention. Amide proton transfer magnetic resonance imaging, a chemical exchange saturation transfer technique, has been used to derive cerebral intracellular pH in preclinical stroke models and has been proposed as a metabolic marker of ischaemic penumbra. In this proof of principle clinical study, we explored the potential of this pH-weighted magnetic resonance imaging technique at tissue-level. Detailed voxel-wise analysis was performed on data from a prospective cohort of 12 patients with acute ischaemic stroke. Voxels within ischaemic core had a more severe intracellular acidosis than hypoperfused tissue recruited to the final infarct (P50.0001), which in turn was more acidotic than hypoperfused tissue that survived (P50.0001). In addition, when confined to the grey matter perfusion deficit, intracellular pH (P50.0001), but not cerebral blood flow (P= 0.31), differed between tissue that infarcted and tissue that survived. Within the presenting apparent diffusion coefficient lesion, intracellular pH differed between tissue with early apparent diffusion lesion pseudonormalization and tissue with true radiographic recovery. These findings support the need for further investigation of pH-weighted imaging in patients with acute ischaemic stroke.
- Publication status:
- Published
- Peer review status:
- Peer reviewed
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(Preview, pdf, 844.5KB, Terms of use)
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- Publisher copy:
- 10.1093/brain/awu374
Authors
- Publisher:
- Oxford University Press
- Journal:
- Brain More from this journal
- Volume:
- 138
- Issue:
- Pt 1
- Pages:
- 36-42
- Publication date:
- 2015-10-01
- Acceptance date:
- 2014-10-01
- DOI:
- EISSN:
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1460-2156
- ISSN:
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0006-8950
- Language:
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English
- Keywords:
- Pubs id:
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pubs:503143
- UUID:
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uuid:a979af71-014a-4b83-8e3a-754885497ac4
- Local pid:
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pubs:503143
- Source identifiers:
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503143
- Deposit date:
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2015-01-16
- ARK identifier:
Terms of use
- Copyright holder:
- Harston et al
- Copyright date:
- 2015
- Notes:
- © The Author (2014). Published by Oxford University Press on behalf of the Guarantors of Brain. This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact [email protected]
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