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Intralesional Patterns of MRI ADC Maps Predict Outcome in Experimental Stroke

机译：MRI ADC映射的内部模式预测实验性卒中的结果

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Background: After acute ischemia, the tissue that is at risk of infarction can be detected by perfusion-weighted imaging/diffusion-weighted imaging (PWI/DWI) mismatch but the time that is needed to process PWI limits its use. As DWI is highly sensitive to acute ischemic tissue damage, we hypothesized that different ADC patterns represent areas with a different potential for recovery. Methods: In a model of permanent middle cerebral artery occlusion (pMCAO), Sprague-Dawley rats were randomly distributed to sham surgery and pMCAO. We further separated the pMCAO group according to intralesional ADC pattern (homogeneous or heterogeneous). At 24 h after ischemia induction, we analyzed lesion size, functional outcome, cell death expression, and brain protection markers including ROS enzyme NOX-4. MRI included DWI (ADC maps), DTI (tractography), and PWI (CBF, CBV and MTT). Results: The lesion size was similar in pMCAO rats. Animals with a heterogeneous pattern in ADC maps showed better functional outcome in Rotarod test (p = 0.032), less expression of cell death (p = 0.014) and NOX-4 (p = 0.0063), higher intralesional CBF (p = 0.0026) and larger PWI/DWI mismatch (p = 0.007). Conclusions: In a rodent model for ischemic stroke, intralesional heterogeneity in ADC maps was related to better functional outcome in lesions of similar size and interval after pMCAO. DWI ADC maps may assist in the early identification of ischemic tissue with an increased potential for recovery as higher expression of acute protection markers, lower expression of cell death, increased PWI/DWI mismatch, and higher intralesional CBF were present in animals with a heterogeneous ADC pattern. (c) 2015 S. Karger AG, Basel
机译：背景：急性缺血后，可以通过灌注加权成像/扩散加权成像（PWI / DWI）不匹配来检测处于梗塞风险的组织，但是处理PWI所需的时间限制了其使用。由于DWI对急性缺血性组织损伤高度敏感，因此我们假设不同的ADC模式代表具有不同恢复潜力的区域。方法：在永久性大脑中动脉闭塞（pMCAO）模型中，将Sprague-Dawley大鼠随机分为假手术和pMCAO。我们根据病变内ADC模式（同质或异质）进一步分离了pMCAO基团。缺血诱导后24小时，我们分析了病变大小，功能结局，细胞死亡表达以及包括ROS酶NOX-4在内的脑保护标记。 MRI包括DWI（ADC图），DTI（放射线照相术）和PWI（CBF，CBV和MTT）。结果：pMCAO大鼠的病变大小相似。 ADC图中具有异质模式的动物在Rotarod试验中显示出更好的功能结局（p = 0.032），细胞死亡的表达较少（p = 0.014）和NOX-4（p = 0.0063），病变内CBF较高（p = 0.0026）和PWI / DWI失配较大（p = 0.007）。结论：在啮齿动物缺血性脑卒中模型中，ADC图的病灶内异质性与pMCAO后相似大小和间隔的病变中更好的功能预后有关。 DWI ADC谱图可能有助于早期鉴定缺血性组织，具有更高的恢复潜力，因为具有异质ADC的动物中存在急性保护标志物的较高表达，细胞死亡的较低表达，PWI / DWI错配增加以及病灶内CBF较高。模式。 （c）2015 S.Karger AG，巴塞尔

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