Article Figures & Data
Figures
- Fig 1.
Segmentation map obtained by using the T1-weighted image shows CSF (blue), white matter (red), and GM (green). The green areas are used for the mean GM CBF measurements.
- Fig 2.
Axial diffusion-weighted, apparent diffusion coefficient (ADC), and quantitative CBF map from patient 2 shows the typical sequelae from anoxic injury, including diffuse bilateral symmetric restricted diffusion in the cerebral cortex (arrow) and the basal ganglia and thalami (arrowhead). The ADC image reflects the subacute nature of the ischemic change, because the imaging was done 9 days after the anoxic event. CBF map shows global hyperperfusion and the second highest average GM blood flow recorded in this study (190.6 mL/100 g of tissue per minute).
- Fig 3.
A, Diffusion, ADC, and quantitative CBF map generated from the PASL sequence obtained in patient 8 one day before the global anoxic event shows restricted diffusion and hypoperfusion in the left posterior watershed territory corresponding with areas of subacute infarction (arrowheads). B, Diffusion, ADC, and quantitative CBF map obtained 3 days after the episode of pulseless electrical activity in patient 8 shows interval worsening of the diffusion abnormality (arrowhead) with new marked global hyperperfusion. There is relative sparing of the previous subacute infarct in the left posterior MCA territory (arrow). Quantitative analysis performed by placing regions of interest over the entire section showed an average CBF increase from 31.4 to 188.6 mL/100 g of tissue per minute.
- Fig 4.
Graph demonstrates rates of global GM CBF (in milliliters per 100 grams per minute), expressed as means ± SDs for 3 groups (infarction negative, infarction positive, and anoxic injury). Rates of global CBF in the anoxic injury group are 109% and 154% higher than rates of CBF in the infarction-negative and infarction-positive control groups, respectively. Data show a statistically significant difference between the anoxic injury and infarction-negative (*) groups and infarction-positive (†) groups. There was no statistically significant difference in global rates of CBF between the infarction-positive and infarction-negative groups.
Tables
Clinical and imaging findings in 16 patients with anoxic injury
Patient/Sex Age, y Etiology of Anoxic Event Event Location and Duration Interval between Event and Imaging, days Pco2, mm Hg Diffusion Restriction Location Average GM CBF, mL/100 g/min Hyperperfusion Pattern Outcome 1/M 56 Hypoglycemia Out, unknown 2 40.8 BG, diffuse cortex 93.5 Unilateral Died 2/M 11 Septic Shock In, unknown 9 32.9 BG, diffuse cortex 190.6 Global Died 3/F 56 Cardiac arrest In, 3 minutes 7 35.4 BG, posterior watershed 79.9 Global, sparing infarct Died 4/M 31 Electrocution Out, unknown 2 39.7 BG, posterior watershed 140.3 Global Persistent Vegetative 5/F 69 PEA Out, unknown 2 42.9 BG, diffuse watershed 144.9 Global Died 6/F 46 Cardiac arrest Out, unknown 6 54 BG 101.7 Global Survived 7/M 75 Cardiac arrest In, unknown 6 33.6 BG, periventricular 142.7 Global Died 8/F 37 PEA In, 30 seconds 3 26.8 Left MCA, bilateral PCA 125.8 Global, sparing infarct Died 9/F 71 Cardiac arrest Out, unknown 2 37.1 Bilateral PCA 107.8 Global, sparing infarct Died 10/M 44 Septic shock Out, unknown 13 36.9 Mild diffuse cortical 146.1 Global Died 11/F 51 Cardiac arrest In, 30 minutes 6 43.2 BG, diffuse cortex 126.2 Global Died 12/F 64 Cardiac arrest Out, unknown 1 45.4 Mild diffuse cortical 188.1 Global Died 13/F 1.5 Seizure Out, 7 minutes 3 37.9 BG, white matter, cortical 204.4 Global Died 14/M 59 Cardiac arrest In, unknown 5 37.3 BG, posterior watershed 177.5 Global Died 15/F 78 Cardiac arrest In, 10 minutes 1 34.9 None 161.7 Global Encephalopathy 16/F 56 Cardiac arrest Out, unknown 6 39.0 None 150.7 Global Short-term memory loss Average 50.3 4.6 days 38.6 142.6 Note:—PEA indicates pulseless electrical activity; In, in hospital; Out, outside hospital; BG, basal ganglia; MCA, middle cerebral artery; PCA, posterior cerebral artery; M, male; F, female; GM, gray matter; CBF, cerebral blood flow; PCO2, partial pressure of carbon dioxide.
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