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Optimized amide proton transfer imaging of ischemic stroke
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Abstracts / Journal of the Neurological Sciences 333 (2013) e215–e278
accurate with CTA, thus giving higher stenosis rates. Postinterventional assessment with DSA is prone to a bias since the intervention is performed under control in one projection. CTA however demonstrated regularly less optimal results in other projections. doi:10.1016/j.jns.2013.07.913
Abstract — WCN 2013 No: 617 Topic: 3 — Stroke Optimized amide proton transfer imaging of ischemic stroke Z. Daia, G. Yana, S. Lia, G. Xiaob, Z. Shena, G. Zhanga, R. Wua. a 2nd Affiliated Hospital of Shantou University Medical College, Shantou, China; bHanshan Normal University, Chaozhou, China Objective: The identification of ischemic penumbra is very important to guide the treatment in ischemic stroke. Amide proton transfer (APT) imaging, a new MRI technology, is expected to detect the ischemic penumbra more precise than PWI–DWI mismatch in hyperacute cerebral infarction. But APT effect is typically small and sensitive to pre-saturation power, which needs to be optimized in the first 3 h after stroke. Material and methods: Twelve adult male Sprague Dawley rats underwent permanent middle cerebral artery occlusion by thread embolism. MRI experiments were conducted under an Agilent 7T animal MRI system in the first 3 h after ischemic stroke. APT imaging was obtained by the home-made APT sequence. Parameters were used: Offset at 3.5 ppm and − 3.5 ppm, TR/TE = 26/2.5 ms, FA = 5°, slice thickness = 2 mm, FOV = 34 × 34 mm^2, NEX = 64, matrix = 64 × 64 and bandwidth = 50 kHz. APT MRI was optimized as functions of pre-saturation power. The pulse power (Gauss pulse, 15 ms) was serially set from 0.4 μT to 1.6 μT with intervals of 0.2 μT. Amide proton transfer imaging and contrast to noise rate (CNR) were processed in Matlab. Results: The optimized pre-saturation power in the first 3 h was 0.6 μT, which had better spatiotemporal resolution and contrast than others. The best CNR was about 4. Moreover, the APT effect almost disappeared when the pre-saturation power was varied more than 0.4 μT. Conclusion: Our study demonstrates the optimized APT imaging in the first 3 h of ischemic stroke, which showed the ischemic lesion precisely and be promising for an accurate gauge of ischemic penumbra. doi:10.1016/j.jns.2013.07.914
Abstract — WCN 2013 No: 2248 Topic: 3 — Stroke Endovascular treatment of acute basilar artery occlusion T. Dorňáka, R. Herziga, D. Školoudíkb, D. Šaňáka, M. Kulihab, M. Roubecb, M. Kocherc, V. Procházkad, M. Krála, T. Veverkaa, M. Heřmanc, J. Zapletalováe, P. Kaňovskya. aNeurology, Faculty of Medicine and Dentistry, Palacky University and University Hospital, Olomouc, Czech Republic; bNeurology, Ostrava University and University Hospital, Ostrava, Czech Republic; cRadiology, Faculty of Medicine and Dentistry, Palacky University and University Hospital, Olomouc, Czech Republic; dRadiology, Faculty of Medicine and Dentistry, Palacky University and University Hospital Ostrava, Ostrava, Czech Republic; eMedical Biophysics, Faculty of Medicine and Dentistry, Institute of Molecular and Translational Medicine, Palacky University Olomouc, Olomouc, Czech Republic
Background: Acute ischemic stroke (AIS) caused by basilar artery occlusion (BAO) is often associated with a severe and persistent neurological deficit and a high mortality rate. Nevertheless, the most effective therapeutic approach has not been established yet. Objective: To evaluate safety and efficacy of multimodal endovascular treatment (ET) of acute BAO, including bridging therapy (intravenous thrombolysis [IVT] with subsequent ET). Patients and methods: In the retrospective, bicenter study, the set consisted of 37 AIS patients (29 males; mean age 60.8 ± 9.2 years) with radiologically confirmed BAO. Following data was collected: baseline characteristics, risk factors, pre-event antithrombotic treatment, neurological deficit at time of treatment, time to therapy, recanalization rate (with successful recanalization defined as Thrombolysis in Cerebral Infarction score 2–3), post-treatment imaging findings. 90-Day outcome was assessed using modified Rankin scale (mRS) with good clinical outcome defined as 0–3 points. Results: The mean National Institutes of Health Stroke Scale score at presentation was 21.3 ± 8.3 points. The mean time to treatment was 5.31 ± 0.13 h. In 17 bridging group patients, mean time from IVT to ET 1.39 ± 0.05 h. Successful recanalization was achieved in 89.2% patients. In patients with BAO recanalization versus those without recanalization, good 90-day clinical outcome was observed in 36.4% versus 0% (p N 0.05), 90-day mortality was 30.3% versus 75.0% (p N 0.05) and mean 90-day mRS was 3.80 versus 5.75 points (p N 0.05). Conclusion: Data in this series showed that multimodal ET was an effective recanalization method of acute BAO. BAO recanalization was associated with lower mortality, but not necessarily with good clinical outcome. doi:10.1016/j.jns.2013.07.915
Abstract — WCN 2013 No: 2234 Topic: 3 — Stroke Influence of acute aneurysmal subarachnoid hemorrhage on subpopulations of mononuclear cells J. Peraa, R. Morgab, E. Grzywnac, T. Dziedzica, M. Moskalac, A. Szczudlika, A. Slowika. aNeurology, Jagiellonian University Medical College, Poland; bNeurosurgery and Neurotraumatology, University Hospital, Poland; cNeurosurgery and Neurotraumatology, Jagiellonian University Medical College, Krakow, Poland Background: Aneurysmal subarachnoid hemorrhage (aSAH) causes specific changes in transcription profiles of peripheral blood cells with a downregulation of transcripts related to T lymphocytes and an upregulation of transcripts related to monocytes and neutrophils. However, it is uncertain whether those changes reflect changes in cell count or in their activities. Objective: To analyze changes in subpopulations of mononuclear cells in the acute phase of aSAH. Patients and methods: Nine patients with acute nontraumatic aSAH (7 females) and 10 control subjects (8 females) were recruited into the study. Flow cytometry method was used to analyze following subpopulations of leukocytes: T lymphocytes (CD3+, CD4+, CD8+, invariant natural killer t cells [iNKT]) and monocytes (classical CD14++CD16-, intermediate CD14++CD16+, nonclassical CD14+CD16++). Results: Significant changes in leukocyte composition with an increase of granulocyte percentage (85.3% vs 63.3%) and a decrease of monocyte (4.9% vs 6.2%) and T lymphocyte (10.0% vs 26.5%) percentages were noted in aSAH patients comparing with controls (p b 0.05). Among monocytes a significant decrease only of nonclassical monocyte count was observed in aSAH patients (p b 0.05). Analysis of subsets of T lymphocytes revealed significantly lower count of CD3+, CD4+, and iNKT in aSAH patients comparing with controls.
Abstracts / Journal of the Neurological Sciences 333 (2013) e215–e278
accurate with CTA, thus giving higher stenosis rates. Postinterventional assessment with DSA is prone to a bias since the intervention is performed under control in one projection. CTA however demonstrated regularly less optimal results in other projections. doi:10.1016/j.jns.2013.07.913
Abstract — WCN 2013 No: 617 Topic: 3 — Stroke Optimized amide proton transfer imaging of ischemic stroke Z. Daia, G. Yana, S. Lia, G. Xiaob, Z. Shena, G. Zhanga, R. Wua. a 2nd Affiliated Hospital of Shantou University Medical College, Shantou, China; bHanshan Normal University, Chaozhou, China Objective: The identification of ischemic penumbra is very important to guide the treatment in ischemic stroke. Amide proton transfer (APT) imaging, a new MRI technology, is expected to detect the ischemic penumbra more precise than PWI–DWI mismatch in hyperacute cerebral infarction. But APT effect is typically small and sensitive to pre-saturation power, which needs to be optimized in the first 3 h after stroke. Material and methods: Twelve adult male Sprague Dawley rats underwent permanent middle cerebral artery occlusion by thread embolism. MRI experiments were conducted under an Agilent 7T animal MRI system in the first 3 h after ischemic stroke. APT imaging was obtained by the home-made APT sequence. Parameters were used: Offset at 3.5 ppm and − 3.5 ppm, TR/TE = 26/2.5 ms, FA = 5°, slice thickness = 2 mm, FOV = 34 × 34 mm^2, NEX = 64, matrix = 64 × 64 and bandwidth = 50 kHz. APT MRI was optimized as functions of pre-saturation power. The pulse power (Gauss pulse, 15 ms) was serially set from 0.4 μT to 1.6 μT with intervals of 0.2 μT. Amide proton transfer imaging and contrast to noise rate (CNR) were processed in Matlab. Results: The optimized pre-saturation power in the first 3 h was 0.6 μT, which had better spatiotemporal resolution and contrast than others. The best CNR was about 4. Moreover, the APT effect almost disappeared when the pre-saturation power was varied more than 0.4 μT. Conclusion: Our study demonstrates the optimized APT imaging in the first 3 h of ischemic stroke, which showed the ischemic lesion precisely and be promising for an accurate gauge of ischemic penumbra. doi:10.1016/j.jns.2013.07.914
Abstract — WCN 2013 No: 2248 Topic: 3 — Stroke Endovascular treatment of acute basilar artery occlusion T. Dorňáka, R. Herziga, D. Školoudíkb, D. Šaňáka, M. Kulihab, M. Roubecb, M. Kocherc, V. Procházkad, M. Krála, T. Veverkaa, M. Heřmanc, J. Zapletalováe, P. Kaňovskya. aNeurology, Faculty of Medicine and Dentistry, Palacky University and University Hospital, Olomouc, Czech Republic; bNeurology, Ostrava University and University Hospital, Ostrava, Czech Republic; cRadiology, Faculty of Medicine and Dentistry, Palacky University and University Hospital, Olomouc, Czech Republic; dRadiology, Faculty of Medicine and Dentistry, Palacky University and University Hospital Ostrava, Ostrava, Czech Republic; eMedical Biophysics, Faculty of Medicine and Dentistry, Institute of Molecular and Translational Medicine, Palacky University Olomouc, Olomouc, Czech Republic
Background: Acute ischemic stroke (AIS) caused by basilar artery occlusion (BAO) is often associated with a severe and persistent neurological deficit and a high mortality rate. Nevertheless, the most effective therapeutic approach has not been established yet. Objective: To evaluate safety and efficacy of multimodal endovascular treatment (ET) of acute BAO, including bridging therapy (intravenous thrombolysis [IVT] with subsequent ET). Patients and methods: In the retrospective, bicenter study, the set consisted of 37 AIS patients (29 males; mean age 60.8 ± 9.2 years) with radiologically confirmed BAO. Following data was collected: baseline characteristics, risk factors, pre-event antithrombotic treatment, neurological deficit at time of treatment, time to therapy, recanalization rate (with successful recanalization defined as Thrombolysis in Cerebral Infarction score 2–3), post-treatment imaging findings. 90-Day outcome was assessed using modified Rankin scale (mRS) with good clinical outcome defined as 0–3 points. Results: The mean National Institutes of Health Stroke Scale score at presentation was 21.3 ± 8.3 points. The mean time to treatment was 5.31 ± 0.13 h. In 17 bridging group patients, mean time from IVT to ET 1.39 ± 0.05 h. Successful recanalization was achieved in 89.2% patients. In patients with BAO recanalization versus those without recanalization, good 90-day clinical outcome was observed in 36.4% versus 0% (p N 0.05), 90-day mortality was 30.3% versus 75.0% (p N 0.05) and mean 90-day mRS was 3.80 versus 5.75 points (p N 0.05). Conclusion: Data in this series showed that multimodal ET was an effective recanalization method of acute BAO. BAO recanalization was associated with lower mortality, but not necessarily with good clinical outcome. doi:10.1016/j.jns.2013.07.915
Abstract — WCN 2013 No: 2234 Topic: 3 — Stroke Influence of acute aneurysmal subarachnoid hemorrhage on subpopulations of mononuclear cells J. Peraa, R. Morgab, E. Grzywnac, T. Dziedzica, M. Moskalac, A. Szczudlika, A. Slowika. aNeurology, Jagiellonian University Medical College, Poland; bNeurosurgery and Neurotraumatology, University Hospital, Poland; cNeurosurgery and Neurotraumatology, Jagiellonian University Medical College, Krakow, Poland Background: Aneurysmal subarachnoid hemorrhage (aSAH) causes specific changes in transcription profiles of peripheral blood cells with a downregulation of transcripts related to T lymphocytes and an upregulation of transcripts related to monocytes and neutrophils. However, it is uncertain whether those changes reflect changes in cell count or in their activities. Objective: To analyze changes in subpopulations of mononuclear cells in the acute phase of aSAH. Patients and methods: Nine patients with acute nontraumatic aSAH (7 females) and 10 control subjects (8 females) were recruited into the study. Flow cytometry method was used to analyze following subpopulations of leukocytes: T lymphocytes (CD3+, CD4+, CD8+, invariant natural killer t cells [iNKT]) and monocytes (classical CD14++CD16-, intermediate CD14++CD16+, nonclassical CD14+CD16++). Results: Significant changes in leukocyte composition with an increase of granulocyte percentage (85.3% vs 63.3%) and a decrease of monocyte (4.9% vs 6.2%) and T lymphocyte (10.0% vs 26.5%) percentages were noted in aSAH patients comparing with controls (p b 0.05). Among monocytes a significant decrease only of nonclassical monocyte count was observed in aSAH patients (p b 0.05). Analysis of subsets of T lymphocytes revealed significantly lower count of CD3+, CD4+, and iNKT in aSAH patients comparing with controls.