Preliminary application of arterial spin labeling and intravoxel incoherent motion in crossed cerebellar diaschisis
Hailong Luo1, Yong Zhang2, Xueying Ling1, Ying Wang1, and Li Huang1

1Medical Imaging Center, the First Affiliated Hospital of Jinan University, Guangzhou, China, People's Republic of, 2GE Healthcare MR Research China, Beijing, China, People's Republic of

Synopsis

In patients with crossed cerebellar diaschisis (CCD), the blood flow and glucose metabolism in the cerebellar was reduced. In this study, arterial spin labeling (ASL) and intravoxel incoherent imaging (IVIM) techniques were used to assess the micro-perfusion change in patients with CCD.

Purpose

Crossed cerebellar diaschisis (CCD) is a common radiological phenomenon manifested as reduced blood flow and glucose metabolism in the cerebellar hemisphere contralateral to a supratentorial cerebral lesion [1]. It is reported that neural function recovery of cerebral infarction patients accompanied with CCD are worse than those without CCD [2]. Intravoxel incoherent motion (IVIM) imaging was performed to separately quantify the diffusion and perfusion characteristics [3,4]. In this work, arterial spin labeling (ASL) and IVIM are performed on cerebral infarction patients with CCD, in order to explore the contributory factor of diffusion and perfusion in CCD.

Methods

45 patients with unilateral supratentorial cerebral infarction or brain stem infarction at our hospital underwent conventional MRI, DWI, ASL perfusion imaging, and 27 of which underwent IVIM scan. The data of ASL perfusion imaging and IVIM scan were transferred to the workstation to be postprocessed. Cerebellar asymmetry index (CSI) was based on rCBF map which calculated from ASL perfusion imaging. All patients were divided into non-CCD group (CSI ≤ 10%) and CCD group (CSI > 10%). Reference to DWI, the volume and rCBF (regional cerebral blood flow) of infarct in two groups were measured and compared by nonparametric tests. D, D*, f, fD* calculated from IVIM scan of bilateral cerebella were recorded and analyzed between two groups by paired t test.

Results

The volume of infarcts of CCD group was larger than non-CCD group (Table.1). There were no statistical differences of rCBF of infarcts between two groups (Table.2). fD*, f of contralateral cerebellar hemisphere declined compared to the ipsilateral hemisphere (Table.3,Table.4) (Fig.1). While the value of D, D* was not significant different between two groups.

Discussions and conclusion

ASL and IVIM imaging can be used to detect CCD of infarction. IVIM imaging can provide more information of hemodynamics. CCD are more likely occurred in larger infarcts which may because larger infarcts are more likely involved cortico-ponto-cerebellar fibers. The degree of reduction of rCBF of infarct was independent of CCD, consistent with previous studies.

Acknowledgements

No acknowledgement found.

References

1. S. Chen, M. Guan, H. J. Lian, L. J. Ma, J. K. Shang, S. He, M. M. Ma, M. L. Zhang, Z. Y. Li, M. Y. Wang, D. P. Shi, and J. W. Zhang, 'Crossed Cerebellar Diaschisis Detected by Arterial Spin-Labeled Perfusion Magnetic Resonance Imaging in Subacute Ischemic Stroke', J Stroke Cerebrovasc Dis, 23 (2014), 2378-83. 2. J. De Reuck, D. Decoo, I. Lemahieu, K. Strijckmans, P. Goethals, and G. Van Maele, 'Crossed Cerebellar Diaschisis after Middle Cerebral Artery Infarction', Clinical Neurology and Neurosurgery, 99, 11-16.

3. Christian Federau, Philippe Maeder, Kieran O’Brien, Patrick Browaeys, Reto Meuli, and Patric Hagmann, 'Quantitative Measurement of Brain Perfusion with Intravoxel Incoherent Motion Mr Imaging', Radiology, 265 (2012), 874-81.

4.D. Le Bihan, E. Breton, D. Lallemand, P. Grenier, E. Cabanis, and M. Laval-Jeantet, 'Mr Imaging of Intravoxel Incoherent Motions: Application to Diffusion and Perfusion in Neurologic Disorders', Radiology, 161 (1986), 401-7.

Figures

Comparison of volume of infarcts between CCD and non-CCD groups

Comparison of rCBF of infarcts between CCD and non-CCD groups

Comparison of D, D*, f and fD* in bilateral cerebella in non-CCD group

Comparison of D, D*, f and fD* in bilateral cerebella in CCD group

A is DWI; B is ASL which showed the perfusion reduced in left cerebellum. C and D are D, D*. E and F are f , fD* which showed signal reduced in left cerebellum.



Proc. Intl. Soc. Mag. Reson. Med. 24 (2016)
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