Imaging the Ischaemic Penumbra using BOLD MRI with oxygen challenge as a metabolic biotracer

中风是一个主要的杀手，比任何其他慢性疾病都有更大的残疾影响。患者占据任何患者组中最大数量的急性住院天数之一（每年260万），并且该疾病消耗NHS支出的4-6%（约28亿英镑），随着预期寿命和存活率的增加，预计到2010年成本将上升30%。治疗选择有限（凝块破坏药物如rt-PA或阿司匹林），只有不到2%的中风患者接受rt-PA治疗，因为出于安全原因，必须在中风后3小时内给予rt-PA，患者必须首先进行脑部扫描以排除脑出血。rt-PA在脑损伤尚未完全发展的患者中非常有效。在中风后的最初几个小时内，受损但可能可挽救的组织（半暗带）可以通过rt-PA挽救。半影组织可以通过磁共振成像（MRI）识别，但目前的技术低估了半影的大小。如果有一种快速、更准确的MRI技术，更多的患者可以接受治疗，并招募到临床试验中研究新的治疗方法。该提案描述了这种技术的开发和验证，并提供了初步的MRI数据，从动物模型和人。

Stroke is a major killer, and has a greater disability impact than any other chronic disease. Patients occupy one of the largest numbers of acute hospital bed days of any patient group (2.6 million per year), and the disease consumes between 4-6% of NHS expenditure (approx £2.8 billion) with costs projected to rise 30% by 2010 as life expectancy and survive rates increase. Treatment options are limited (clot busting drugs like rt-PA or aspirin) with less than 2% of stroke patients receiving rt-PA since it must be given within 3 hours of stroke for safety reasons, and patients must have a brain scan first to rule out brain haemorrhage. rt-PA is very effective in patients where brain damage has not fully evolved. In the first few hours after stroke, injured but potentially salvageable tissue (penumbra) can be saved by rt-PA. Penumbral tissue can be identified by magnetic resonance imaging (MRI), but current techniques underestimate penumbra size. If a rapid, more accurate MRI technique was available, more patients could be treated and recruitment into clinical trials to study new therapies, improved. This proposal describes development and validation of such a technique and provides preliminary MRI data from animal models and man.