Journal
AMERICAN JOURNAL OF NEURORADIOLOGY
Volume 30, Issue 4, Pages 710-715Publisher
AMER SOC NEURORADIOLOGY
DOI: 10.3174/ajnr.A1435
Keywords
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Funding
- NCRR NIH HHS [P41 RR015241-040002, K12 RR017627, P41RR15241, P41 RR015241] Funding Source: Medline
- NIDCD NIH HHS [R01 DC005375-11, R01 DC005375] Funding Source: Medline
- NINDS NIH HHS [R01 NS047691-08, R01 NS R01047691, R01 NS047691] Funding Source: Medline
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BACKGROUND AND PURPOSE: Crossed cerebellar diaschisis (CCD), the decrease in blood flow and metabolism in the cerebellar hemisphere contralateral to a supratentorial stroke, is frequently reported on positron-emission tomography (PET) and single-photon emission CT (SPECT) but is rarely described with MR perfusion techniques. This study was undertaken to determine the frequency of CCD observed in acute stroke by retrospective review of a research data base of patients with acute stroke evaluated by diffusion-weighted (DWI) and dynamic contrast susceptibility perfusion MR imaging (PWI). MATERIALS AND METHODS: PWI scans of 301 consecutive patients with acute stroke and positive DWI abnormality from a research data base were reviewed. Contralateral cerebellar hypoperfusion was identified by inspection of time-to-peak (TTP) maps for asymmetry with an absence of cerebellar abnormalities on T2-weighted scans, DWI, or disease of the vertebrobasilar system on MR angiography. In a subset of the cases, quantitative analysis of perfusion scans was performed using an arterial input function and singular value decomposition (SVD) to generate cerebral blood flow (CBF) maps. RESULTS: A total of 47 of 301 cases (15.61 %) met the criteria of CCD by asymmetry of cerebellar perfusion on TTP maps. On quantitative analysis, there was corresponding reduction of CBF by 22.75 +/- 10.94% (range, 7.45% to 52.13%) of the unaffected cerebellar hemisphere). CONCLUSIONS: MR perfusion techniques can be used to detect CCD, though the frequency presented in this series is lower than that commonly reported in the PET/SPECT literature. Nevertheless, with its role in acute stroke and noninvasive nature, MB perfusion may be a viable alternative to PET or SPECT to study the phenomenon and clinical consequences of supratentorial stroke with CCD.
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