Perfluorocarbons enhance a T2*-based MRI technique for identifying the penumbra in a rat model of acute ischemic stroke

J Cereb Blood Flow Metab. 2013 Sep;33(9):1422-8. doi: 10.1038/jcbfm.2013.86. Epub 2013 Jun 26.

Abstract

Accurate imaging of ischemic penumbra is crucial for improving the management of acute stroke patients. T2* magnetic resonance imaging (MRI) combined with a T2*oxygen challenge (T2*OC) is being developed to detect penumbra based on changes in blood deoxyhemoglobin. Using 100% O2, T2*OC-defined penumbra exhibits ongoing glucose metabolism and tissue recovery on reperfusion. However, potential limitations in translating this technique include a sinus artefact in human scans with delivery of 100% OC and relatively small signal changes. Here we investigate whether an oxygen-carrying perfluorocarbon (PFC) emulsion can enhance the sensitivity of the technique, enabling penumbra detection with lower levels of inspired oxygen. Stroke was induced in male Sprague-Dawley rats (n=17) with ischemic injury and perfusion deficit determined by diffusion and perfusion MRI, respectively. T2* signal change was measured in regions of interest (ROIs) located within ischemic core, T2*OC-defined penumbra and equivalent contralateral areas during 40% O2±prior PFC injection. Region of interest analyses between groups showed that PFC significantly enhanced the T2* response to 40% O2 in T2*-defined penumbra (mean increase of 10.6±2.3% compared to 5.6±1.5% with 40% O2, P<0.001). This enhancement was specific to the penumbra ROI. Perfluorocarbon emulsions therefore enhances the translational potential of the T2*OC technique for identifying penumbra in acute stroke patients.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Animals
  • Blood Substitutes / pharmacology*
  • Brain Ischemia* / diagnostic imaging
  • Brain Ischemia* / metabolism
  • Contrast Media / pharmacology*
  • Disease Models, Animal
  • Fluorocarbons / pharmacology*
  • Hemoglobins / metabolism
  • Humans
  • Magnetic Resonance Imaging / methods*
  • Male
  • Oxygen / metabolism
  • Radiography
  • Rats
  • Rats, Sprague-Dawley
  • Stroke* / diagnostic imaging
  • Stroke* / metabolism

Substances

  • Blood Substitutes
  • Contrast Media
  • Fluorocarbons
  • Hemoglobins
  • deoxyhemoglobin
  • Oxygen