This Article  • References  • Full text PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Contact me when this article is cited  Related Content  • Similar articles in JAMA  Social Bookmarking   What's this?

Marc Fisher, MD; James W. Prichard, MD; Steven Warach, MD, PhD

JAMA. 1995;274(11):908-911.

Abstract
Neuroimaging was revolutionized by the development of computed tomography (CT) and standard T₁- and T₂-weighted magnetic resonance imaging (MRI). Magnetic resonance imaging and CT can adequately distinguish hemorrhage from infarction and depict ischemic stroke 12 to 24 hours after onset. However, during the critical initial hours after the onset of ischemic stroke, these imaging technologies do not adequately demonstrate the location and extent of infarction. Diffusion-weighted MRI and perfusion imaging, as well as advances in magnetic resonance spectroscopy, will enhance our ability to evaluate ischemic stroke shortly after onset. Some of the uses of MRI techniques are as follows: (1) Diffusion-weighted imaging can depict the location and extent of the ischemic lesion as soon as a stroke patient is available for examination. (2) Perfusion imaging evaluates blood flow within the brain's microvasculature and can reveal regions of perfusion deficits corresponding to major vascular territories. (3) Magnetic resonance spectroscopy evaluates metabolic abnormalties associated with focal brain ischemia by specific biochemical measurements. These MRI techniques will rapidly provide important information to clinicians about ischemia, guiding diagnosis and helping in the development of acute stroke interventions to improve outcome.

(JAMA. 1995;274:908-911)

Author Affiliations
From the Departments of Neurology, the Medical Center of Central Massachusetts and the University of Massachusetts Medical School, Worcester (Dr Fisher); Department of Neurology, Yale University School of Medicine, New Haven, Conn (Dr Prichard); and Departments of Neurology, Beth Israel Hospital and Harvard Medical School, Boston, Mass (Dr Warach).

Footnotes
Reprint requests to Medical Center of Central Massachusetts, 119 Belmont St, Worcester, MA 01605 (Dr Fisher).

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

The technology of MRI -- the next 10 years?
BLAMIRE
Br. J. Radiol. 2008;81:601-617.
ABSTRACT | FULL TEXT  

Extent of white matter lesions is related to acute subcortical infarcts and predicts further stroke risk in patients with first ever ischaemic stroke
Fu et al.
J. Neurol. Neurosurg. Psychiatry 2005;76:793-796.
ABSTRACT | FULL TEXT  

Tissue at Risk Is Overestimated in Perfusion-Weighted Imaging: MR Imaging in Acute Stroke Patients without Vessel Recanalization
Kucinski et al.
Am. J. Neuroradiol. 2005;26:815-819.
ABSTRACT | FULL TEXT  

Evaluation of brain injury after coronary artery bypass grafting. A prospective study using neuropsychological assessment and diffusion-weighted magnetic resonance imaging
Knipp et al.
Eur. J. Cardiothorac. Surg. 2004;25:791-800.
ABSTRACT | FULL TEXT  

Abnormal Brain Diffusivity in Patients with Neuropsychiatric Systemic Lupus Erythematosus
Bosma et al.
Am. J. Neuroradiol. 2003;24:850-854.
ABSTRACT | FULL TEXT  

Diffusion- and Perfusion-Weighted Magnetic Resonance Imaging of the Brain Before and After Coronary Artery Bypass Grafting Surgery
Restrepo et al.
Stroke 2002;33:2909-2915.
ABSTRACT | FULL TEXT  

Advances in intravenous thrombolytic therapy for treatment of acute stroke
Albers
Neurology 2001;57:S77-81.
ABSTRACT | FULL TEXT  

Perfusion Magnetic Resonance Imaging Maps in Hyperacute Stroke : Relative Cerebral Blood Flow Most Accurately Identifies Tissue Destined to Infarct
Parsons et al.
Stroke 2001;32:1581-1587.
ABSTRACT | FULL TEXT  

A Model for Multiparametric MRI Tissue Characterization in Experimental Cerebral Ischemia With Histological Validation in Rat : Part 1
Jacobs et al.
Stroke 2001;32:943-949.
ABSTRACT | FULL TEXT  

Thrombolysis in acute ischaemic stroke
Pereira et al.
Postgrad. Med. J. 2001;77:166-171.
FULL TEXT  

Is Early Ischemic Lesion Volume on Diffusion-Weighted Imaging an Independent Predictor of Stroke Outcome? : A Multivariable Analysis
Thijs et al.
Stroke 2000;31:2597-2602.
ABSTRACT | FULL TEXT  

Intra-arterial Prourokinase for Acute Ischemic Stroke: The PROACT II Study: A Randomized Controlled Trial
Furlan et al.
JAMA 1999;282:2003-2011.
ABSTRACT | FULL TEXT  

Expanding the Window for Thrombolytic Therapy in Acute Stroke : The Potential Role of Acute MRI for Patient Selection
Albers
Stroke 1999;30:2230-2237.
ABSTRACT | FULL TEXT  

A Standardized MRI Stroke Protocol : Comparison with CT in Hyperacute Intracerebral Hemorrhage
Schellinger et al.
Stroke 1999;30:765-768.
ABSTRACT | FULL TEXT  

Newer Sequences for Spinal MR Imaging: Smorgasbord or Succotash of Acronyms?
Ross
Am. J. Neuroradiol. 1999;20:361-373.
FULL TEXT  

Intra-Arterial rtPA Treatment of Stroke Assessed by Diffusion- and Perfusion-Weighted MRI
Lansberg et al.
Stroke 1999;30:678-680.
ABSTRACT | FULL TEXT  

Diffusion-Weighted Magnetic Resonance Imaging in a Case of Cerebral Venous Thrombosis
Corvol et al.
Stroke 1998;29:2649-2652.
ABSTRACT | FULL TEXT  

Delayed reduction of tissue water diffusion after myocardial ischemia
Hsu et al.
Am. J. Physiol. Heart Circ. Physiol. 1998;275:H697-H702.
ABSTRACT | FULL TEXT  

Relation between cerebral blood flow and neurologic deficit resolution in acute ischemic stroke
Firlik et al.
Neurology 1998;51:177-182.
ABSTRACT | FULL TEXT  

Further Evolution Toward Effective Therapy for Acute Ischemic Stroke
Fisher and Bogousslavsky
JAMA 1998;279:1298-1303.
ABSTRACT | FULL TEXT  

A Novel Endothelin Antagonist, A-127722, Attenuates Ischemic Lesion Size in Rats With Temporary Middle Cerebral Artery Occlusion : A Diffusion and Perfusion MRI Study • Editorial Comment: A Diffusion and Perfusion MRI Study
Tatlisumak et al.
Stroke 1998;29:850-858.
ABSTRACT | FULL TEXT  

Timing of Carotid Endarterectomy After Stroke
Pritz
Stroke 1997;28:2563-2567.
ABSTRACT | FULL TEXT  

Quantitative Cerebral Blood Flow Determinations in Acute Ischemic Stroke : Relationship to Computed Tomography and Angiography
Firlik et al.
Stroke 1997;28:2208-2213.
ABSTRACT | FULL TEXT  

Characterizing the Target of Acute Stroke Therapy
Fisher
Stroke 1997;28:866-872.
ABSTRACT | FULL TEXT  

Evidence-Based Medicine, Critical Pathways, Practice Guidelines, and Managed Care: Reflections on the Prevention and Care of Stroke
Ringel and Hughes
Arch Neurol 1996;53:867-871.
ABSTRACT  

Radiology
Evens
JAMA 1996;275:1854-1855.
ABSTRACT