Article Figures & Data
Figures
- Fig 1.
Diagrammatic representation of the distribution of CBF following acute obstruction of an artery supplying blood to the brain. There is a reduction in the CBF to the area of the brain that was perfused by the artery. This reduction in CBF is most severe in the central perfusion territory of the artery and becomes increasingly less so in more peripheral areas where collateral circulation from other arteries provides additional flow.
- Fig 2.
Diagrammatic representation of the state of brain tissue following acute obstruction of an artery supplying blood to the brain. For the sake of simplicity, the different tissue states are shown as concentric rings. In reality, cells from the different types of tissue will be intermixed to some degree.
- Fig 3.
Neuroimaging of preventable infarction requires 3 neuroimaging signals that spatially match the 3 pathophysiologic tissue types in the brain with acute cerebral ischemia: dead (signal A), preventable infarction (signal B), not at risk (signal C). The state of the tissue is in gray-scale. Imaging results are in color.
- Fig 4.
The demonstration in untreated patients that signal A reliably predicts 100% cell death, that signal C reliable predicts 100% cell survival, and that signal B has an indeterminate outcome is not sufficient to conclude that signal B accurately identifies preventable infarction. Simply because region B is homogeneous in its neuroimaging characteristics does not mean it is homogeneous biochemically and pathophysiologically. It may be a mixture of dead cells and tissue not at risk between which signal B cannot distinguish (lower row). The state of the tissue is in gray-scale. Imaging results are in color.
Tables
Criteria to establish accurate neuroimaging of preventable infarction
Imaging Signal A Imaging Signal B Imaging Signal C Untreated tissue All die All die All survive Treated tissue All die All survive All survive
