Magnetization transfer imaging shows tissue abnormalities in the reversible penumbra.

T. Tourdias, V. Dousset, I. Sibon, E. Pele, P. Menegon, J. Asselineau, C. Pachai, F. Rouanet, P. Robinson, G. Chene, J. M. Orgogozo
Stroke. 2007-10-25; 38(12): 3165-3171
DOI: 10.1161/strokeaha.107.483925

PubMed
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1. Stroke. 2007 Dec;38(12):3165-71. Epub 2007 Oct 25.

Magnetization transfer imaging shows tissue abnormalities in the reversible
penumbra.

Tourdias T(1), Dousset V, Sibon I, Pele E, Menegon P, Asselineau J, Pachai C,
Rouanet F, Robinson P, Chene G, Orgogozo JM.

Author information:
(1)CHU de Bordeaux, Université Victor Segalen Bordeaux 2, Service de
Neuroradiologie diagnostique et thérapeutique, Place Amélie Raba-Léon, Bordeaux,
France.

BACKGROUND AND PURPOSE: In the concept of ischemic penumbra, the volume of
salvaged penumbra is considered as the volume of 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 FLAIR normalization was a good marker for tissue full
recovery.
METHODS: We prospectively included 30 patients with acute middle cerebral artery
stroke. Diffusion-weighted imaging (DWI) and perfusion-weighted imaging were
performed within 12 hours after onset (MRI.1), and the final infarct was
documented by MRI with FLAIR and magnetization transfer at 1-month follow-up
(MRI.2). We compared magnetic transfer ratio of a normal region with values
measured at 1 month (MRI.2) in 4 regions of interest: (1) the initial DWI
hypersignal (CORE=DWI MRI.1); (2) the infarct growth area (infarct growth=FLAIR
MRI.2-DWI MRI.1); (3) the hypoperfused area that normalized (reversible perfusion
abnormalities=perfusion-weighted imaging MRI.1-FLAIR_ MRI.2); and (4) the early
DWI abnormalities that normalized (reversible diffusion abnormalities=DWI MRI.1-
FLAIR_MRI.2).
RESULTS: In comparison with values obtained in normal tissue (magnetic transfer
ratio=49.8%, SD=1.9), magnetic transfer ratio at 1 month was significantly
decreased in reversible perfusion abnormalities (45.2%, SD=2.5; P

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