The overall goal of this research is to evaluate diffusion- and perfusion-weighted MR methodologies for the diagnostic advantages and predictive value they bring to the management of clinical stroke. At present, identification of stroke relies primarily on neurological assessment rather than physiological measurement, since the ability to study ischemic pathophysiology in humans has been limited. Rapid identification of the relevant lesions represents a particularly difficult challenge. We believe that diffusion- and perfusion-sensitive MRI techniques can improve the management of stroke in these regions by rapidly providing diagnostic information that is not available from neurological assessments and that cannot be obtained by presently-used CT or conventional MRI methods. We will focus on diffusion-weighted (DWI), perfusion-weighted MR (PWI), and time-resolved vascular MR imaging because of its inherent sensitivity to cellular energy failure and to the underlying hemodynamic behaviors. During all years of funding, parameters of stroke severity (volume, location, and circulation) measured by MR will be correlated to acute and chronic stroke severity measured by neurological assessments based on the National Institutes of Health Stroke Scale Scores (NIHSSS) and the Bamford Classification, and to the final T2-weighted images. We will build a comprehensive database of stroke severity (volume, location, and circulation) from both large and small strokes (anterior and posterior) from 24 patients per year.
Our aims are to determine the correlation of diffusion- and perfusion-weighted MR parameters of stroke severity with clinical assessment of stroke severity at the acute timepoint, identify diagnostic predictors of the clinical outcome of stroke, and to derive the relationship between vascular risk and metabolic status. The successful completion of this work will deliver an integrated battery of MR measurements best predictive of stroke severity and clinical outcome. It will also provide objective criteria beyond the neurological exam and a rapid, non-invasive tool for the neurologist to improve the diagnosis and management of patients with acute stroke.

Agency
National Institute of Health (NIH)
Institute
National Institute of Neurological Disorders and Stroke (NINDS)
Type
Research Project (R01)
Project #
5R01NS035959-03
Application #
2892192
Study Section
Diagnostic Radiology Study Section (RNM)
Program Officer
Jacobs, Tom P
Project Start
1997-06-12
Project End
2001-03-31
Budget Start
1999-04-01
Budget End
2001-03-31
Support Year
3
Fiscal Year
1999
Total Cost
Indirect Cost
Name
Stanford University
Department
Radiation-Diagnostic/Oncology
Type
Schools of Medicine
DUNS #
800771545
City
Stanford
State
CA
Country
United States
Zip Code
94305
Liu, Chunlei; Bammer, Roland; Moseley, Michael E (2007) Parallel imaging reconstruction for arbitrary trajectories using k-space sparse matrices (kSPA). Magn Reson Med 58:1171-81
Pagani, E; Bammer, R; Horsfield, M A et al. (2007) Diffusion MR imaging in multiple sclerosis: technical aspects and challenges. AJNR Am J Neuroradiol 28:411-20
Bammer, Roland; Hope, Thomas A; Aksoy, Murat et al. (2007) Time-resolved 3D quantitative flow MRI of the major intracranial vessels: initial experience and comparative evaluation at 1.5T and 3.0T in combination with parallel imaging. Magn Reson Med 57:127-40
Mlynash, Michael; Eyngorn, Irina; Bammer, Roland et al. (2005) Automated method for generating the arterial input function on perfusion-weighted MR imaging: validation in patients with stroke. AJNR Am J Neuroradiol 26:1479-86
Liu, Chunlei; Moseley, Michael E; Bammer, Roland (2005) Simultaneous phase correction and SENSE reconstruction for navigated multi-shot DWI with non-cartesian k-space sampling. Magn Reson Med 54:1412-22
D'Arceuil, H E; de Crespigny, A J; Pelc, L et al. (2005) A comparison of CH3-DTPA-GD (NMS60) and GD-DTPA for evaluation of acute myocardial ischemia. Int J Cardiovasc Imaging 21:539-47
Liu, Chunlei; Bammer, Roland; Moseley, Michael E (2005) Limitations of apparent diffusion coefficient-based models in characterizing non-gaussian diffusion. Magn Reson Med 54:419-28
Augustin, Michael; Fazekas, Franz; Bammer, Roland (2004) Fast patient workup in acute stroke using parallel imaging. Top Magn Reson Imaging 15:207-19
Liu, Chunlei; Bammer, Roland; Kim, Dong-Hyun et al. (2004) Self-navigated interleaved spiral (SNAILS): application to high-resolution diffusion tensor imaging. Magn Reson Med 52:1388-96
Liu, Chunlei; Bammer, Roland; Acar, Burak et al. (2004) Characterizing non-Gaussian diffusion by using generalized diffusion tensors. Magn Reson Med 51:924-37

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