Diffusion-weighted MRI and proton MR spectroscopic imaging in the study of secondary neuronal injury after intracerebral hemorrhage

Juan Carhuapoma, Paul Y. Wang, Norman J. Beauchamp, Penelope M. Keyl, Daniel F Hanley, Peter B Barker

Research output: Contribution to journalArticle

Abstract

Background and Purpose - Cerebral ischemia has been proposed as contributing mechanism to secondary neuronal injury after intracerebral hemorrhage (ICH). Possible tools for investigating this hypothesis are diffusion-weighted (DWI) and proton magnetic resonance spectroscopic imaging (1H-MRSI). However, magnetic field inhomogeneity induced by paramagnetic blood products may prohibit the application of such techniques on perihematoma tissue. We report on the feasibility of DWI and 1H-MRSI in the study of human ICH and present preliminary data on their contribution to understanding perihematoma tissue functional and metabolic profiles. Methods - Patients with acute supratentorial ICH were prospectively evaluated using DWI and 1H-MRSI. Obscuration of perihematoma tissue with both sequences was assessed. Obtainable apparent diffusion coefficient (Dav) and lactate spectra in perihematoma brain tissue were recorded and analyzed. Results - Nine patients with mean age of 63.4 (36 to 87) years were enrolled. Mean time from symptom onset to initial MRI was 3.4 (1 to 9) days; mean hematoma volume was 35.4 (5 to 80) cm3. Perihematoma diffusion values were attainable in 9 of 9 patients, and 1H-MRSI measures were obtainable in 5 of 9 cases. Dav in perihematoma regions was 172.5 (120.0 to 302.5) x 10-5 mm2/s and 87.6 (76.5 to 102.1)x 10-5 mm2/s in contralateral corresponding regions of interest (P=0.002). One patient showed an additional area of reduced Dav with normal T2 intensity, which suggests ischemia. 1H-MRSI revealed lactate surrounding the hematoma in 2 patients. Conclusions - DWI and 1H-MRSI can be used in the study of ICH patients. Our preliminary data are inconsistent with ischemia as the primary mechanism for perihematoma tissue injury. Further investigation with advanced MRI techniques will give a clearer understanding of the role that ischemia plays in tissue injury after ICH.

Original languageEnglish (US)
Pages (from-to)726-732
Number of pages7
JournalStroke
Volume31
Issue number3
StatePublished - Mar 2000

Fingerprint

Diffusion Magnetic Resonance Imaging
Cerebral Hemorrhage
Protons
Wounds and Injuries
Ischemia
Hematoma
Lactic Acid
Metabolome
Magnetic Fields
Brain Ischemia
Magnetic Resonance Imaging
Brain

Keywords

  • Diffusion- weighted
  • Intracerebral hemorrhage
  • Magnetic resonance imaging
  • Neuronal damage
  • Nuclear magnetic resonance
  • Spectroscopy

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Neuroscience(all)

Cite this

Diffusion-weighted MRI and proton MR spectroscopic imaging in the study of secondary neuronal injury after intracerebral hemorrhage. / Carhuapoma, Juan; Wang, Paul Y.; Beauchamp, Norman J.; Keyl, Penelope M.; Hanley, Daniel F; Barker, Peter B.

In: Stroke, Vol. 31, No. 3, 03.2000, p. 726-732.

Research output: Contribution to journalArticle

@article{bea725ac05744eafb45d9c39a825e5b9,
title = "Diffusion-weighted MRI and proton MR spectroscopic imaging in the study of secondary neuronal injury after intracerebral hemorrhage",
abstract = "Background and Purpose - Cerebral ischemia has been proposed as contributing mechanism to secondary neuronal injury after intracerebral hemorrhage (ICH). Possible tools for investigating this hypothesis are diffusion-weighted (DWI) and proton magnetic resonance spectroscopic imaging (1H-MRSI). However, magnetic field inhomogeneity induced by paramagnetic blood products may prohibit the application of such techniques on perihematoma tissue. We report on the feasibility of DWI and 1H-MRSI in the study of human ICH and present preliminary data on their contribution to understanding perihematoma tissue functional and metabolic profiles. Methods - Patients with acute supratentorial ICH were prospectively evaluated using DWI and 1H-MRSI. Obscuration of perihematoma tissue with both sequences was assessed. Obtainable apparent diffusion coefficient (Dav) and lactate spectra in perihematoma brain tissue were recorded and analyzed. Results - Nine patients with mean age of 63.4 (36 to 87) years were enrolled. Mean time from symptom onset to initial MRI was 3.4 (1 to 9) days; mean hematoma volume was 35.4 (5 to 80) cm3. Perihematoma diffusion values were attainable in 9 of 9 patients, and 1H-MRSI measures were obtainable in 5 of 9 cases. Dav in perihematoma regions was 172.5 (120.0 to 302.5) x 10-5 mm2/s and 87.6 (76.5 to 102.1)x 10-5 mm2/s in contralateral corresponding regions of interest (P=0.002). One patient showed an additional area of reduced Dav with normal T2 intensity, which suggests ischemia. 1H-MRSI revealed lactate surrounding the hematoma in 2 patients. Conclusions - DWI and 1H-MRSI can be used in the study of ICH patients. Our preliminary data are inconsistent with ischemia as the primary mechanism for perihematoma tissue injury. Further investigation with advanced MRI techniques will give a clearer understanding of the role that ischemia plays in tissue injury after ICH.",
keywords = "Diffusion- weighted, Intracerebral hemorrhage, Magnetic resonance imaging, Neuronal damage, Nuclear magnetic resonance, Spectroscopy",
author = "Juan Carhuapoma and Wang, {Paul Y.} and Beauchamp, {Norman J.} and Keyl, {Penelope M.} and Hanley, {Daniel F} and Barker, {Peter B}",
year = "2000",
month = "3",
language = "English (US)",
volume = "31",
pages = "726--732",
journal = "Stroke",
issn = "0039-2499",
publisher = "Lippincott Williams and Wilkins",
number = "3",

}

TY - JOUR

T1 - Diffusion-weighted MRI and proton MR spectroscopic imaging in the study of secondary neuronal injury after intracerebral hemorrhage

AU - Carhuapoma, Juan

AU - Wang, Paul Y.

AU - Beauchamp, Norman J.

AU - Keyl, Penelope M.

AU - Hanley, Daniel F

AU - Barker, Peter B

PY - 2000/3

Y1 - 2000/3

N2 - Background and Purpose - Cerebral ischemia has been proposed as contributing mechanism to secondary neuronal injury after intracerebral hemorrhage (ICH). Possible tools for investigating this hypothesis are diffusion-weighted (DWI) and proton magnetic resonance spectroscopic imaging (1H-MRSI). However, magnetic field inhomogeneity induced by paramagnetic blood products may prohibit the application of such techniques on perihematoma tissue. We report on the feasibility of DWI and 1H-MRSI in the study of human ICH and present preliminary data on their contribution to understanding perihematoma tissue functional and metabolic profiles. Methods - Patients with acute supratentorial ICH were prospectively evaluated using DWI and 1H-MRSI. Obscuration of perihematoma tissue with both sequences was assessed. Obtainable apparent diffusion coefficient (Dav) and lactate spectra in perihematoma brain tissue were recorded and analyzed. Results - Nine patients with mean age of 63.4 (36 to 87) years were enrolled. Mean time from symptom onset to initial MRI was 3.4 (1 to 9) days; mean hematoma volume was 35.4 (5 to 80) cm3. Perihematoma diffusion values were attainable in 9 of 9 patients, and 1H-MRSI measures were obtainable in 5 of 9 cases. Dav in perihematoma regions was 172.5 (120.0 to 302.5) x 10-5 mm2/s and 87.6 (76.5 to 102.1)x 10-5 mm2/s in contralateral corresponding regions of interest (P=0.002). One patient showed an additional area of reduced Dav with normal T2 intensity, which suggests ischemia. 1H-MRSI revealed lactate surrounding the hematoma in 2 patients. Conclusions - DWI and 1H-MRSI can be used in the study of ICH patients. Our preliminary data are inconsistent with ischemia as the primary mechanism for perihematoma tissue injury. Further investigation with advanced MRI techniques will give a clearer understanding of the role that ischemia plays in tissue injury after ICH.

AB - Background and Purpose - Cerebral ischemia has been proposed as contributing mechanism to secondary neuronal injury after intracerebral hemorrhage (ICH). Possible tools for investigating this hypothesis are diffusion-weighted (DWI) and proton magnetic resonance spectroscopic imaging (1H-MRSI). However, magnetic field inhomogeneity induced by paramagnetic blood products may prohibit the application of such techniques on perihematoma tissue. We report on the feasibility of DWI and 1H-MRSI in the study of human ICH and present preliminary data on their contribution to understanding perihematoma tissue functional and metabolic profiles. Methods - Patients with acute supratentorial ICH were prospectively evaluated using DWI and 1H-MRSI. Obscuration of perihematoma tissue with both sequences was assessed. Obtainable apparent diffusion coefficient (Dav) and lactate spectra in perihematoma brain tissue were recorded and analyzed. Results - Nine patients with mean age of 63.4 (36 to 87) years were enrolled. Mean time from symptom onset to initial MRI was 3.4 (1 to 9) days; mean hematoma volume was 35.4 (5 to 80) cm3. Perihematoma diffusion values were attainable in 9 of 9 patients, and 1H-MRSI measures were obtainable in 5 of 9 cases. Dav in perihematoma regions was 172.5 (120.0 to 302.5) x 10-5 mm2/s and 87.6 (76.5 to 102.1)x 10-5 mm2/s in contralateral corresponding regions of interest (P=0.002). One patient showed an additional area of reduced Dav with normal T2 intensity, which suggests ischemia. 1H-MRSI revealed lactate surrounding the hematoma in 2 patients. Conclusions - DWI and 1H-MRSI can be used in the study of ICH patients. Our preliminary data are inconsistent with ischemia as the primary mechanism for perihematoma tissue injury. Further investigation with advanced MRI techniques will give a clearer understanding of the role that ischemia plays in tissue injury after ICH.

KW - Diffusion- weighted

KW - Intracerebral hemorrhage

KW - Magnetic resonance imaging

KW - Neuronal damage

KW - Nuclear magnetic resonance

KW - Spectroscopy

UR - http://www.scopus.com/inward/record.url?scp=0034063956&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0034063956&partnerID=8YFLogxK

M3 - Article

C2 - 10700511

AN - SCOPUS:0034063956

VL - 31

SP - 726

EP - 732

JO - Stroke

JF - Stroke

SN - 0039-2499

IS - 3

ER -