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MRI Methods Applied to Stroke

  • Bradley J. MacIntoshEmail author
  • Simon J. Graham
Chapter

Abstract

Diagnostic imaging is an invaluable aspect of clinical stroke medicine, providing the location, volume, and the nature of the stroke lesion. Anatomical stroke imaging typically has been done with computed tomography (CT), but ever increasingly is supplanted by the superb soft tissue contrast provided by magnetic resonance imaging (MRI). It is more cumbersome to obtain MRI in acute stroke patients; so at many centers, CT remains the initial screening test, with or without contrast administration (CT angiography, CT perfusion). This rapidly differentiates ischemic from hemorrhagic stroke and can then guide acute management, for example, with thrombolytics. The versatility of MRI methods, however, also enables much more detailed biophysical information to be obtained about stroke physiology, above and beyond lesion structure. For example, just after stroke onset, diffusion-weighted MRI (DWI) and perfusion-weighted MRI (PWI) provide information about diffusion of water molecules and microvascular blood flow within brain tissue, respectively. The DWI and PWI methods help to evaluate the ischemic zone surrounding infarcted tissue that is potentially salvageable by recanalization therapies. Magnetic resonance angiography (MRA) approaches are also available to characterize larger-scale vasculature. In the post-acute and chronic phases, functional MRI (fMRI) offers the ability to detect alterations in brain activation patterns post-stroke, either associated with a particular behavioral task or during the resting state. Lastly, it is also possible now to image blood flow in the brain noninvasively using arterial spin labeling (ASL) MRI. In this chapter, we provide a biophysical understanding of these and other basic MRI methods and discuss their application to stroke recovery.

Keywords

Stroke Patient Fractional Anisotropy Diffusion Tensor Imaging Arterial Spin Label Bold Signal 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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Copyright information

© Springer Science+Business Media New York 2014

Authors and Affiliations

  1. 1.Department of Medical BiophysicsUniversity of TorontoTorontoCanada
  2. 2.Sunnybrook Research Institute, Sunnybrook Health Sciences CentreTorontoCanada
  3. 3.Heart and Stroke Foundation, Centre of Stroke RecoveryTorontoCanada

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