An essential goal of stroke research is to identify potentially salvageable regions of brain that may respond to therapy. However, current imaging methods are inadequate for this purpose. We therefore used dynamic magnetic resonance imaging of vascular reactivity following focal occlusion in the rat to determine whether measurement of perfusion reserve would help resolve this problem. We used the increase in blood-oxygen-level-dependent (BOLD) signal that occurs in normal brain following a CO2 challenge, to map vascular reactivity over the brain at 30-min intervals for 3.5 h after complete (CO) or partial (PO) focal ischemia. We assessed the regional correspondence between reactivity changes and areas of lowered apparent diffusion coefficient (ADC) and initial perfusion deficit. The area of lowered ADC was significantly smaller in the PO group compared to the CO group despite similar areas of perfusion deficit (P < 0.05). We identified four distinct areas within hypoperfused brain: a core area with low/absent reactivity and low ADC; borderzone areas with normal reactivity and either reduced ADC (CO group) or normal ADC (PO group); and an area with normal ADC and reduced/absent reactivity. In all ischemic regions, the BOLD peak arrival time in the brain was delayed or absent. There was a negative correlation between BOLD peak latency time and ADC (r = -0.42, P < 0.001), although latency alone did not differentiate individual ischemic regions. In conclusion, combining perfusion, ADC, and vascular reactivity mapping of the ischemic brain enables improved discrimination of core and borderzone regions.
Copyright 2001 Academic Press.