MR-based cerebral blood volume maps as a diagnostic tool of stroke: Results of a clinical pilot study

Purpose: In this study the sensitivity of proving a stroke using regional cerebral blood volume (rCBV) maps were investigated. Another aim was to evaluate the strength of the ischaemia. Methods: Seven patients were examinated during the acute phase of a stroke, eight during the subacute or chronically stage. To calculate rCBV-maps of one slice low dosed Gd-DTPA was injected as a bolus. Using the relaxation-effect the obtained signal intensity-time curves were converted pixel-wise to rCBV images. For the region of the infarction rCBV ratios were calculated relative to the corresponding area in the contralateral hemisphere. Results: Only 63% of the investigations carried out during the acute phase were utilizable. In all those cases a decrease of rCBV was found. The infarct area could only visually recognized if the rCBV ratio was lower than 0.7. The ratios of completely and partial necrotic areas of the infarctions were 0.481 and 1.028 respectively. With a p = 0.0015 these values are even statistically different. Conclusions: During the acute stage the sensitivity of the rCBV measurement was not as high as that of morpho logical MR imaging. However, rCBV maps make it possible to estimate the strength of the ischaemia even during the first hours.