PubMed · 8827823
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P P Livett. Strip drip.. https://pubmed.ncbi.nlm.nih.gov/8827823/
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Various functional imaging modalities can be applied in acute ischaemic stroke to identify functionally impaired, but morphologically preserved tissue (i.e. the penumbra), and to distinguish it from irreversibly damaged tissue. Flow thresholds for irreversible tissue destruction resulting in functional impairment, as determined by positron emission tomography, perfusion and diffusion-weighted magnetic resonance imaging, single-photon computed tomography and xenon computed tomography, were comparable and ranged between 5 and 12 ml/100 g per min for the lower and 14 and 22 ml/100 g per min for the upper limit of penumbra. These imaging modalities help to select patients for thrombolytic therapy and provide evidence for the effect of this treatment on critically perfused tissue. They can also serve as surrogate markers in the evaluation of therapeutic efficacy. Further progress in interventional neuroradiology has been achieved with intra-arterial thrombolysis, which has become a treatment option beyond the 3-h therapeutic window in acute ischaemic stroke. Angioplasty and stenting of stenosis of arteries that supply the brain with blood have reached a point in their development at which a randomized trial to compare these treatments with vascular surgery is warranted.
PURPOSE: To assess the accuracy of an interpolated breath-hold T1-weighted three-dimensional (3D) gradient-echo (GRE) magnetic resonance (MR) imaging sequence with near-isotropic pixel size (</=2.3 mm) for evaluation of hepatic arterial anatomy variants during dynamic liver parenchymal imaging and to report patterns of hepatic arterial anatomy. MATERIALS AND METHODS: Liver MR imaging, including an interpolated breath-hold 3D GRE sequence with fat suppression (4.2/1.8 [repetition time msec/echo time msec], 12 degrees flip angle), was performed in 207 consecutive patients before and after gadopentetate dimeglumine administration. Of the 207 patients, 202 (98%) had technically satisfactory studies clearly defining the hepatic arterial system. The first contrast material-enhanced GRE acquisition was timed for optimal arterial enhancement with a timing examination. In a retrospective review, hepatic arteries were evaluated on the basis of arterial phase images interpreted by two independent readers using transverse source images complemented by multiplanar reconstructions. Twenty-three patients also underwent digital subtraction angiography, which was a reference standard for comparison. RESULTS: Conventional hepatic arterial anatomy was demonstrated in 135 (67%) of 202 patients. In the 23 patients with angiographic correlation, no discrepancy was noted between MR imaging and digital subtraction angiographic findings. CONCLUSION: Hepatic arterial anatomy can be reliably demonstrated during liver parenchymal imaging with an optimally timed contrast-enhanced isotropic 3D GRE sequence.