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Ann Thorac Surg 2000;70:1795
© 2000 The Society of Thoracic Surgeons

Scientific abstract

Is diffusion and perfusion magnetic resonance imaging sufficiently sensitive to quantify small, new, ischemic insults associated with behavioral dysfunction after cardiac and nonvascular surgery?

M.D. Baker, E.M. Martin, D.M. Moody, A.S. Field, J.H. Burdette, Y.-F. Yen, D.D. Durden, J.W. Hammon, D.A. Stump

Departments of Radiology and Anesthesiology, Cardiothoracic Surgery, Pathology, and eMedical Engineering, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA

Magnetic resonance (MR) diffusion-weighted imaging (DWI) has been recognized as a method for the early detection of ischemic brain injury. MR perfusion-weighted imaging (PWI) measures the absolute or relative blood flow within cerebral tissues and is traditionally performed by PET, SPECT, contrasted CT or MR studies. Arterial spin-labeled (SAL) MR is a newer technique that evaluates perfusion without exogenous tracer and yields traditional units of cerebral blood flow (ie, mL/100 g-min). We have developed and reported on the reproducibility of the spiral acquisition ASL-PWI we employ [1].

We have begun investigation of DWI and PWI studies in patients undergoing cardiac surgery, which may identify important areas of brain that sustain ischemic injury. PWI in the group of postcoronary bypass patients thus far has demonstrated asymmetric perfusion in some patients by as much as 19.0%, which is not seen in our asymptomatic normal volunteers, who have an average asymmetry of only 0.9% ± 6.5%. This noninvasive MR perfusion technique warrants further investigation for the role it might play in understanding the pathophysiology of the postoperative deficits observed by neuropsychological testing in these patients.

Footnotes

Supported by a grant from the National Institutes of Health (NS-38242), Medtronic, Inc., Minneapolis, MN, and a grant from the Charles A. Dana Foundation

References

  1. Yen Y-F, Takahashi AM, Martin EM, Burdette JH, Hernandez L, Moody DM. Quantitative evaluation of vasomotor reactivity by acetazolamide challenge using FAIR perfusion MRI. Proceedings to the International Society of Magnetic Resonance in Medicine Eight Scientific Meeting. Denver, CO, April 1–7, 2000.





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