Magnetization Transfer Imaging Shows Tissue Abnormalities in the Reversible Penumbra

• DOI: 10.1161/strokeaha.107.483925
• Publication Date: 2007-10-25T23:46:10Z
• Authors: Thomas Tourdias; Vincent Dousset; Igor Sibon; Eric Pele; Patrice Menegon; Julien Asselineau; Chahin Pachai; François Rouanet; Philip Robinson; Geneviève Chene; Jean Marc Orgogozo
• Keywords: Penumbra; Fluid-attenuated inversion recovery; Magnetization transfer

In the concept of ischemic penumbra, volume salvaged penumbra is considered as FLAIR normalization on follow-up MRI compared with early diffusion and perfusion abnormalities. Using magnetization transfer imaging, very sensitive to macromolecular disruption, we investigated whether was a good marker for tissue full recovery.We prospectively included 30 patients acute middle cerebral artery stroke. Diffusion-weighted imaging (DWI) perfusion-weighted were performed within 12 hours after onset (MRI.1), final infarct documented by at 1-month (MRI.2). We magnetic ratio normal region values measured 1 month (MRI.2) in 4 regions interest: (1) initial DWI hypersignal (CORE=DWI MRI.1); (2) growth area (infarct growth=FLAIR MRI.2-DWI (3) hypoperfused that normalized (reversible abnormalities=perfusion-weighted MRI.1-FLAIR_ MRI.2); (4) abnormalities abnormalities=DWI MRI.1- FLAIR_MRI.2).In comparison obtained (magnetic ratio=49.8%, SD=1.9), significantly decreased reversible (45.2%, SD=2.5; P<0.0001) (43.2%, SD=2.8; P=0.0156). It also markedly reduced, expected, CORE (40.9%, SD=5.2) (43.1%, SD=2.0).Magnetic assessed presence microstructural damages MRI-defined penumbra. This may imply cellular loss partial infarction. Evaluation efficacy therapies promote reperfusion or neuroprotection benefit from this additional information.