Evidence map›Paper›PMID 27879446›Full record

Observational studyStroke2017

Quantification of Serial Cerebral Blood Flow in Acute Stroke Using Arterial Spin Labeling.

George W J Harston, Thomas W Okell, Fintan Sheerin, Ursula Schulz, Phil Mathieson, Ian Reckless, Kunal Shah, Gary A Ford, Michael A Chappell, Peter Jezzard and 1 more

Abstract readObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in Stroke, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers.

0numbers the graph read from it
0cells of the map it votes in
21citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

21 citing papers in PubMed.

  1. Elevated brain oxygen extraction fraction measured by MRI susceptibility relates to perfusion status in acute ischemic stroke.Journal of cerebral blood flow and metabolism : official journal of the International Society of Cerebral Blood Flow and Metabolism · 2020
    Trial
  2. Article
  3. Review
  4. Article
  5. Article
  6. Recent advances in arterial spin labeling perfusion MRI in patients with vascular cognitive impairment.Journal of cerebral blood flow and metabolism : official journal of the International Society of Cerebral Blood Flow and Metabolism · 2023
    Review
  7. Article
  8. Review
  9. Article
  10. TissueJournal of cerebral blood flow and metabolism : official journal of the International Society of Cerebral Blood Flow and Metabolism · 2021
    Article
  11. Study Protocol: The Heart and Brain Study.Frontiers in physiology · 2021
    Article
  12. Article
  13. Transcranial contrast-enhanced ultrasound in the rat brain reveals substantial hyperperfusion acutely post-stroke.Journal of cerebral blood flow and metabolism : official journal of the International Society of Cerebral Blood Flow and Metabolism · 2020
    Article
  14. Non-invasive monitoring of longitudinal changes in cerebral hemodynamics in acute ischemic stroke using BOLD signal delay.Journal of cerebral blood flow and metabolism : official journal of the International Society of Cerebral Blood Flow and Metabolism · 2020
    Article
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  16. Observational
  17. Observational
  18. Article
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  20. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

George W J HarstonFrom the Acute Vascular Imaging Centre, Radcliffe Department of Medicine, University of Oxford, United Kingdom (G.W.J.H., J.K.); Oxford Centre for Functional MRI of the Brain, Nuffield Department of Clinical Neurosciences, University of Oxford, United Kingdom (T.W.O., M.A.C., P.J.); Department of Neuroradiology (F.S.) and Acute Stroke Service (U.S., P.M., I.R., K.S., G.A.F., J.K.), Oxford University Hospitals NHS Foundation Trust, United Kingdom; Institute of Biomedical Engineering, Department of Engineering Science, University of Oxford, United Kingdom (M.A.C.). george.harston@rdm.ox.ac.uk.
Thomas W OkellFrom the Acute Vascular Imaging Centre, Radcliffe Department of Medicine, University of Oxford, United Kingdom (G.W.J.H., J.K.); Oxford Centre for Functional MRI of the Brain, Nuffield Department of Clinical Neurosciences, University of Oxford, United Kingdom (T.W.O., M.A.C., P.J.); Department of Neuroradiology (F.S.) and Acute Stroke Service (U.S., P.M., I.R., K.S., G.A.F., J.K.), Oxford University Hospitals NHS Foundation Trust, United Kingdom; Institute of Biomedical Engineering, Department of Engineering Science, University of Oxford, United Kingdom (M.A.C.).
Fintan SheerinFrom the Acute Vascular Imaging Centre, Radcliffe Department of Medicine, University of Oxford, United Kingdom (G.W.J.H., J.K.); Oxford Centre for Functional MRI of the Brain, Nuffield Department of Clinical Neurosciences, University of Oxford, United Kingdom (T.W.O., M.A.C., P.J.); Department of Neuroradiology (F.S.) and Acute Stroke Service (U.S., P.M., I.R., K.S., G.A.F., J.K.), Oxford University Hospitals NHS Foundation Trust, United Kingdom; Institute of Biomedical Engineering, Department of Engineering Science, University of Oxford, United Kingdom (M.A.C.).
Ursula SchulzFrom the Acute Vascular Imaging Centre, Radcliffe Department of Medicine, University of Oxford, United Kingdom (G.W.J.H., J.K.); Oxford Centre for Functional MRI of the Brain, Nuffield Department of Clinical Neurosciences, University of Oxford, United Kingdom (T.W.O., M.A.C., P.J.); Department of Neuroradiology (F.S.) and Acute Stroke Service (U.S., P.M., I.R., K.S., G.A.F., J.K.), Oxford University Hospitals NHS Foundation Trust, United Kingdom; Institute of Biomedical Engineering, Department of Engineering Science, University of Oxford, United Kingdom (M.A.C.).
Phil MathiesonFrom the Acute Vascular Imaging Centre, Radcliffe Department of Medicine, University of Oxford, United Kingdom (G.W.J.H., J.K.); Oxford Centre for Functional MRI of the Brain, Nuffield Department of Clinical Neurosciences, University of Oxford, United Kingdom (T.W.O., M.A.C., P.J.); Department of Neuroradiology (F.S.) and Acute Stroke Service (U.S., P.M., I.R., K.S., G.A.F., J.K.), Oxford University Hospitals NHS Foundation Trust, United Kingdom; Institute of Biomedical Engineering, Department of Engineering Science, University of Oxford, United Kingdom (M.A.C.).
Ian RecklessFrom the Acute Vascular Imaging Centre, Radcliffe Department of Medicine, University of Oxford, United Kingdom (G.W.J.H., J.K.); Oxford Centre for Functional MRI of the Brain, Nuffield Department of Clinical Neurosciences, University of Oxford, United Kingdom (T.W.O., M.A.C., P.J.); Department of Neuroradiology (F.S.) and Acute Stroke Service (U.S., P.M., I.R., K.S., G.A.F., J.K.), Oxford University Hospitals NHS Foundation Trust, United Kingdom; Institute of Biomedical Engineering, Department of Engineering Science, University of Oxford, United Kingdom (M.A.C.).
Kunal ShahFrom the Acute Vascular Imaging Centre, Radcliffe Department of Medicine, University of Oxford, United Kingdom (G.W.J.H., J.K.); Oxford Centre for Functional MRI of the Brain, Nuffield Department of Clinical Neurosciences, University of Oxford, United Kingdom (T.W.O., M.A.C., P.J.); Department of Neuroradiology (F.S.) and Acute Stroke Service (U.S., P.M., I.R., K.S., G.A.F., J.K.), Oxford University Hospitals NHS Foundation Trust, United Kingdom; Institute of Biomedical Engineering, Department of Engineering Science, University of Oxford, United Kingdom (M.A.C.).
Gary A FordFrom the Acute Vascular Imaging Centre, Radcliffe Department of Medicine, University of Oxford, United Kingdom (G.W.J.H., J.K.); Oxford Centre for Functional MRI of the Brain, Nuffield Department of Clinical Neurosciences, University of Oxford, United Kingdom (T.W.O., M.A.C., P.J.); Department of Neuroradiology (F.S.) and Acute Stroke Service (U.S., P.M., I.R., K.S., G.A.F., J.K.), Oxford University Hospitals NHS Foundation Trust, United Kingdom; Institute of Biomedical Engineering, Department of Engineering Science, University of Oxford, United Kingdom (M.A.C.).
Michael A ChappellFrom the Acute Vascular Imaging Centre, Radcliffe Department of Medicine, University of Oxford, United Kingdom (G.W.J.H., J.K.); Oxford Centre for Functional MRI of the Brain, Nuffield Department of Clinical Neurosciences, University of Oxford, United Kingdom (T.W.O., M.A.C., P.J.); Department of Neuroradiology (F.S.) and Acute Stroke Service (U.S., P.M., I.R., K.S., G.A.F., J.K.), Oxford University Hospitals NHS Foundation Trust, United Kingdom; Institute of Biomedical Engineering, Department of Engineering Science, University of Oxford, United Kingdom (M.A.C.).
Peter JezzardFrom the Acute Vascular Imaging Centre, Radcliffe Department of Medicine, University of Oxford, United Kingdom (G.W.J.H., J.K.); Oxford Centre for Functional MRI of the Brain, Nuffield Department of Clinical Neurosciences, University of Oxford, United Kingdom (T.W.O., M.A.C., P.J.); Department of Neuroradiology (F.S.) and Acute Stroke Service (U.S., P.M., I.R., K.S., G.A.F., J.K.), Oxford University Hospitals NHS Foundation Trust, United Kingdom; Institute of Biomedical Engineering, Department of Engineering Science, University of Oxford, United Kingdom (M.A.C.).
James KennedyFrom the Acute Vascular Imaging Centre, Radcliffe Department of Medicine, University of Oxford, United Kingdom (G.W.J.H., J.K.); Oxford Centre for Functional MRI of the Brain, Nuffield Department of Clinical Neurosciences, University of Oxford, United Kingdom (T.W.O., M.A.C., P.J.); Department of Neuroradiology (F.S.) and Acute Stroke Service (U.S., P.M., I.R., K.S., G.A.F., J.K.), Oxford University Hospitals NHS Foundation Trust, United Kingdom; Institute of Biomedical Engineering, Department of Engineering Science, University of Oxford, United Kingdom (M.A.C.).

Funding

Department of Health OXFBRC-2012-1The Dunhill Medical Trust OSRP1/1006Wellcome Trust 088877
6 · The paper itself

Abstract

background and purposePerfusion-weighted imaging is used to select patients with acute ischemic stroke for intervention, but knowledge of cerebral perfusion can also inform the understanding of ischemic injury. Arterial spin labeling allows repeated measurement of absolute cerebral blood flow (CBF) without the need for exogenous contrast. The aim of this study was to explore the relationship between dynamic CBF and tissue outcome in the month after stroke onset.

methodsPatients with nonlacunar ischemic stroke underwent ≤5 repeated magnetic resonance imaging scans at presentation, 2 hours, 1 day, 1 week, and 1 month. Imaging included vessel-encoded pseudocontinuous arterial spin labeling using multiple postlabeling delays to quantify CBF in gray matter regions of interest. Receiver-operator characteristic curves were used to predict tissue outcome using CBF. Repeatability was assessed in 6 healthy volunteers and compared with contralateral regions of patients. Diffusion-weighted and T2-weighted fluid attenuated inversion recovery imaging were used to define tissue outcome.

resultsForty patients were included. In contralateral regions of patients, there was significant variation of CBF between individuals, but not between scan times (mean±SD: 53±42 mL/100 g/min). Within ischemic regions, mean CBF was lowest in ischemic core (17±23 mL/100 g/min), followed by regions of early (21±26 mL/100 g/min) and late infarct growth (25±35 mL/100 g/min; ANOVA P<0.0001). Between patients, there was marked overlap in presenting and serial CBF values.

conclusionsKnowledge of perfusion dynamics partially explained tissue fate. Factors such as metabolism and tissue susceptibility are also likely to influence tissue outcome.

Indexed as

Perfusion ImagingSpin LabelsAgedAged, 80 and overCerebrovascular CirculationCohort StudiesFemaleHumansMaleMiddle AgedProspective StudiesStrokeSpin Labelsbiomarkerscerebral infarctionmagnetic resonance imagingperfusion imagingstroke

Identifiers

PMID27879446
PMCPMC5175999

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.