Evidence map›Paper›PMID 28345479›Full record

ReviewJournal of cerebral blood flow and metabolism : official journal of the International Society of Cerebral Blood Flow and Metabolism2018

Imaging the physiological evolution of the ischemic penumbra in acute ischemic stroke.

Richard Leigh, Linda Knutsson, Jinyuan Zhou, Peter Cm van Zijl

Abstract readReview
In one paragraph

Review in Journal of cerebral blood flow and metabolism : official journal of the International Society of Cerebral Blood Flow and Metabolism, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 100 papers.

0numbers the graph read from it
0cells of the map it votes in
100citing 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

100 citing papers in PubMed.

  1. Trial
  2. 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
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  18. Amide proton transfer MRI may reflect effective reperfusion and predict functional outcomes in patients with ischemic stroke.Journal of cerebral blood flow and metabolism : official journal of the International Society of Cerebral Blood Flow and Metabolism · 2025
    Article
  19. International journal of molecular sciences · 2025
    Article
  20. Blood-brain barrier breakdown in brain ischemia: Insights from MRI perfusion imaging.Neurotherapeutics : the journal of the American Society for Experimental NeuroTherapeutics · 2025
    Review

40 more citing papers are in PubMed but not listed here.

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

4 authors.

Richard Leigh1 National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, USA.
Linda Knutsson2 Department of Medical Radiation Physics, Lund University, Lund, Sweden.
Jinyuan Zhou3 Department of Radiology, Johns Hopkins University, Baltimore, MD, USA.
Peter Cm van Zijl3 Department of Radiology, Johns Hopkins University, Baltimore, MD, USA.

Funding

TR&D 4: Algorithms for functional and anatomical brain analysisP41EB015909 · NIBIB · HUGO W. MOSER RES INST KENNEDY KRIEGER · PI VAN ZIJL, PETER CM · 2012 to 2020
$13.1M
Using MRI to Understand Disease States that Occur at the Interface of the Brain and the Cerebral CirculationZIANS003151 · NINDS · NATIONAL INSTITUTE OF NEUROLOGICAL DISORDERS AND STROKE · PI LEIGH, RICHARD · 2015 to 2023
$6.8M
US-China Collaborative Research on Stroke ImagingR01NS083435 · NINDS · JOHNS HOPKINS UNIVERSITY · PI ZHOU, JINYUAN · 2013 to 2015
$588k
NIBIB NIH HHS P41 EB015909NINDS NIH HHS R01 NS083435
6 · The paper itself

Abstract

We review the hemodynamic, metabolic and cellular parameters affected during early ischemia and their changes as a function of approximate cerebral blood flow ( CBF) thresholds. These parameters underlie the current practical definition of an ischemic penumbra, namely metabolically affected but still viable brain tissue. Such tissue is at risk of infarction under continuing conditions of reduced CBF, but can be rescued through timely intervention. This definition will be useful in clinical diagnosis only if imaging techniques exist that can rapidly, and with sufficient accuracy, visualize the existence of a mismatch between such a metabolically affected area and regions that have suffered cell depolarization. Unfortunately, clinical data show that defining the outer boundary of the penumbra based solely on perfusion-related thresholds may not be sufficiently accurate. Also, thresholds for CBF and cerebral blood volume ( CBV) differ for white and gray matter and evolve with time for both inner and outer penumbral boundaries. As such, practical penumbral imaging would involve parameters in which the physiology is immediately displayed in a manner independent of baseline CBF or CBF threshold, namely pH, oxygen extraction fraction ( OEF), diffusion constant and mean transit time ( MTT). Suitable imaging technologies will need to meet this requirement in a 10-20 min exam.

Indexed as

BrainBrain IschemiaCerebrovascular CirculationHumansNeuroimagingPerfusion ImagingStrokeAcidosisischemic penumbrametabolismMRIperfusionpHphysiologic evolution

Identifiers

PMID28345479
PMCPMC6125975

What OpenQuestion holds

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Read underepoch 390

Registered trials

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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.