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  Elevated brain oxygen extraction fraction measured by MRI susceptibility relates to perfusion status in acute ischemic stroke

Fan, A. P., Khalil, A., Fiebach, J. B., Zaharchuk, G., Villringer, A., Villringer, K., et al. (2020). Elevated brain oxygen extraction fraction measured by MRI susceptibility relates to perfusion status in acute ischemic stroke. Journal of Cerebral Blood Flow and Metabolism, 40(3), 539-551. doi:10.1177/0271678X19827944.

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Fan, Audrey P.1, Author
Khalil, Ahmed2, 3, 4, Author              
Fiebach, Jochen B.2, Author
Zaharchuk, Greg1, Author
Villringer, Arno3, 4, Author              
Villringer, Kersten2, Author
Gauthier, Claudine J.5, 6, Author
1Department of Radiology, Stanford University, CA, USA, ou_persistent22              
2Center for Stroke Research, Charité University Medicine Berlin, Germany, ou_persistent22              
3Department Neurology, MPI for Human Cognitive and Brain Sciences, Max Planck Society, ou_634549              
4Berlin School of Mind and Brain, Humboldt University Berlin, Germany, ou_persistent22              
5Department of Physics, Concordia University, Montréal, QC, Canada, ou_persistent22              
6Montreal Heart Institute, QC, Canada, ou_persistent22              


Free keywords: Acute ischemic stroke; MRI; Oxygen extraction fraction; Penumbra; Quantitative susceptibility mapping
 Abstract: Recent clinical trials of new revascularization therapies in acute ischemic stroke have highlighted the importance of physiological imaging to identify optimal treatments for patients. Oxygen extraction fraction (OEF) is a hallmark of at-risk tissue in stroke, and can be quantified from the susceptibility effect of deoxyhemoglobin molecules in venous blood on MRI phase scans. We measured OEF within cerebral veins using advanced quantitative susceptibility mapping (QSM) MRI reconstructions in 20 acute stroke patients. Absolute OEF was elevated in the affected (29.3 ± 3.4%) versus the contralateral hemisphere (25.5 ± 3.1%) of patients with large diffusion–perfusion lesion mismatch (P = 0.032). In these patients, OEF negatively correlated with relative CBF measured by dynamic susceptibility contrast MRI (P = 0.004), suggesting compensation for reduced flow. Patients with perfusion–diffusion match or no hypo-perfusion showed less OEF difference between hemispheres. Nine patients received longitudinal assessment and showed OEF ratio (affected to contralateral) of 1.2 ± 0.1 at baseline that normalized (decreased) to 1.0 ± 0.1 at follow-up three days later (P = 0.03). Our feasibility study demonstrates that QSM MRI can non-invasively quantify OEF in stroke patients, relates to perfusion status, and is sensitive to OEF changes over time. Clinical trial registration: Longitudinal MRI examinations of patients with brain ischemia and blood brain barrier permeability; clinicaltrials.org : NCT02077582.


Language(s): eng - English
 Dates: 2018-12-062018-09-102018-12-312019-02-072020-03-01
 Publication Status: Published in print
 Pages: -
 Publishing info: -
 Table of Contents: -
 Rev. Type: Peer
 Identifiers: DOI: 10.1177/0271678X19827944
PMID: 30732551
Other: Epub ahead of print
 Degree: -



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Project name : -
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Funding program : Interdisciplinary Scholar Award
Funding organization : Neurosciences Institute, Stanford University
Project name : -
Grant ID : -
Funding program : National New Investigator Award
Funding organization : Heart and Stroke Foundation of Canada
Project name : -
Grant ID : 1K99NS102884
Funding program : -
Funding organization : National Institutes of Health (NIH)

Source 1

Title: Journal of Cerebral Blood Flow and Metabolism
Source Genre: Journal
Publ. Info: New York : Lippincott Williams & Wilkins
Pages: - Volume / Issue: 40 (3) Sequence Number: - Start / End Page: 539 - 551 Identifier: ISSN: 0271-678X
CoNE: https://pure.mpg.de/cone/journals/resource/954925503202