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  Relationship between changes in the temporal dynamics of the blood-oxygen-level-dependent signal and hypoperfusion in acute ischemic stroke

Khalil, A., Ostwaldt, A.-C., Nierhaus, T., Ganeshan, R., Audebert, H. J., Villringer, K., et al. (2017). Relationship between changes in the temporal dynamics of the blood-oxygen-level-dependent signal and hypoperfusion in acute ischemic stroke. Stroke, 48(4), 925-931. doi:10.1161/STROKEAHA.116.015566.

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Item Permalink: http://hdl.handle.net/21.11116/0000-0002-D014-C Version Permalink: http://hdl.handle.net/21.11116/0000-0003-C7FD-0
Genre: Journal Article

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 Creators:
Khalil, Ahmed1, Author              
Ostwaldt, Ann-Christin2, Author
Nierhaus, Till1, Author              
Ganeshan, Ramanan2, Author
Audebert , Heinrich J.2, Author
Villringer, Kersten2, Author
Villringer, Arno1, Author              
Fiebach, Jochen B.2, Author
Affiliations:
1Department Neurology, MPI for Human Cognitive and Brain Sciences, Max Planck Society, ou_634549              
2External Organizations, ou_persistent22              

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Free keywords: perfusion imaging, BOLD delay, gadolinium, stroke, blood volume, brain
 Abstract: Background and Purpose— Changes in the blood-oxygen-level-dependent (BOLD) signal provide a noninvasive measure of blood flow, but a detailed comparison with established perfusion parameters in acute stroke is lacking. We investigated the relationship between BOLD signal temporal delay and dynamic susceptibility contrast magnetic resonance imaging (DSC-MRI) in stroke patients. Methods— In 30 patients with acute (<24 hours) ischemic stroke, we performed Pearson correlation and multiple linear regression between DSC-MRI parameters (time to maximum [Tmax], mean transit time, cerebral blood flow, and cerebral blood volume) and BOLD-based parameters (BOLD delay and coefficient of BOLD variation). Prediction of severe hypoperfusion (Tmax >6 seconds) was assessed using receiver–operator characteristic (ROC) analysis. Results— Correlation was highest between Tmax and BOLD delay (venous sinus reference; time shift range 7; median r=0.60; interquartile range=0.49–0.71). Coefficient of BOLD variation correlated with cerebral blood volume (median r= 0.37; interquartile range=0.24–0.51). Mean R2 for predicting BOLD delay by DSC-MRI was 0.54 (SD=0.2) and for predicting coefficient of BOLD variation was 0.37 (SD=0.17). BOLD delay (whole-brain reference, time shift range 3) had an area under the curve of 0.76 for predicting severe hypoperfusion (sensitivity=69.2%; specificity=80%), whereas BOLD delay (venous sinus reference, time shift range 3) had an area under the curve of 0.76 (sensitivity=67.3%; specificity=83.5%). Conclusions— BOLD delay is related to macrovascular delay and microvascular hypoperfusion, can identify severely hypoperfused tissue in acute stroke, and is a promising alternative to gadolinium contrast agent–based perfusion assessment in acute stroke.

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Language(s): eng - English
 Dates: 2016-12-242016-09-272017-01-242017-03-082017-04
 Publication Status: Published in print
 Pages: -
 Publishing info: -
 Table of Contents: -
 Rev. Method: Peer
 Identifiers: DOI: 10.1161/STROKEAHA.116.015566
PMID: 28275197
Other: Epub 2017
 Degree: -

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Project name : -
Grant ID : 01EO0801 ; 01EO01301
Funding program : -
Funding organization : German Federal Ministry of Education and Research (BMBF)
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Grant ID : -
Funding program : NeuroCure Cluster of Excellence PhD Fellowship
Funding organization : Charite - University Medicine Berlin

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Title: Stroke
Source Genre: Journal
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Publ. Info: Philadelphia, PA : Lippincott Williams & Wilkins
Pages: - Volume / Issue: 48 (4) Sequence Number: - Start / End Page: 925 - 931 Identifier: ISSN: 0039-2499
CoNE: https://pure.mpg.de/cone/journals/resource/954925447729