Time course of circulatory and metabolic recovery of cat brain after cardiac arrest assessed by perfusion- and diffusion-weighted imaging and MR-spectroscopy
Time course of circulatory and metabolic recovery of cat brain after cardiac arrest assessed by perfusion- and diffusion-weighted imaging and MR-spectroscopy
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DOI：
10.1016/s0300-9572(03)00151-5
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发表时间：
2003-09-01
期刊：
影响因子：
6.5
通讯作者：
Hossmann, KA
中科院分区：
文献类型：
--
作者：
Krep, H;Böttiger, BW;Hossmann, KA
使用动脉自旋标记灌注加权成像 (PWI)、扩散加权成像 (DWI) 和 H-1 能谱 (H-1-MRS) 评估猫心脏骤停 (CA) 后的脑恢复情况。心肺复苏 (CPR) 后 6 小时监测皮质和基底神经节的脑再灌注和代谢恢复。此外，还评估了心肺复苏期间应用的高渗/高渗溶液（7.5% NaCl/6% 羟乙基淀粉，HES）和组织型纤溶酶原激活剂（TPA）对脑恢复的影响。 CA 和 CPR 是通过远程控制在 MR 扫描仪中进行的。通过心脏电颤动诱导 15-20 分钟的 CA，然后使用气动背心进行心肺复苏。成功心肺复苏后的 PWI 显示最初的脑灌注过度，随后出现迟发性低灌注。渗透治疗后初始脑再循环得到改善。渗透疗法和溶栓疗法对于改善迟发性低灌注无效。 DWI 表观扩散系数 (ADC) 的计算表明所有动物的离子和水稳态完全恢复。乳酸的 1H-MRS 测量表明 TPA 治疗后缺血后无氧代谢的延长保存。无创磁共振技术的结合是评估实验性脑缺血后循环和代谢脑恢复治疗策略的有力工具。 (C) 2003 Elsevier Ireland Ltd. 保留所有权利。
Brain recovery after cardiac arrest (CA) was assessed in cats using arterial spin tagging perfusion-weighted imaging (PWI), diffusion-weighted imaging (DWI), and H-1-spectroscopy (H-1-MRS). Cerebral reperfusion and metabolic recovery was monitored in the cortex and in basal ganglia for 6 h after cardiopulmonary resuscitation (CPR). Furthermore, the effects of an hypertonic/hyperoncotic solution (7.5% NaCl/6% hydroxyl ethyl starch, HES) and a tissue-type plasminogen activator (TPA), applied during CPR, were assessed on brain recovery. CA and CPR were carried out in the MR scanner by remote control. CA for 15-20 min was induced by electrical fibrillation of the heart, followed by CPR using a pneumatic vest. PWI after successful CPR revealed initial cerebral hyperperfusion followed by delayed hypoperfusion. Initial cerebral recirculation was improved after osmotic treatment. Osmotic and thrombolytic therapy were ineffective in ameliorating delayed hypoperfusion. Calculation of the apparent diffusion coefficient (ADC) from DWI demonstrated complete recovery of ion and water homeostasis in all animals. 1H-MRS measurements of lactate suggested an extended preservation of post-ischaemic anaerobic metabolism after TPA treatment. The combination of noninvasive MR techniques is a powerful tool for the evaluation of therapeutical strategies on circulatory and metabolic cerebral recovery after experimental cerebral ischaemia. (C) 2003 Elsevier Ireland Ltd. All rights reserved.