Crossed cerebellar diaschisis after stroke detected noninvasively by arterial spin-labeling MR imaging
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RESEARCH ARTICLE
BMC Neuroscience Open Access
Crossed cerebellar diaschisis after stroke detected noninvasively by arterial spin‑labeling MR imaging Juan Wang1,2† , Li‑Jun Pan1†, Bin Zhou1,2, Jin‑Yan Zu1,2, Yi‑Xu Zhao1, Yang Li2, Wan‑Qiu Zhu1, Lei Li2, Jian‑Rong Xu1 and Zeng‑Ai Chen1,2*
Abstract Background: As a noninvasive perfusion-weighted MRI technique, arterial spin-labeling (ASL) was becoming increas‑ ingly used to evaluate cerebral hemodynamics in many studies. The relation between ASL-MRI and crossed cerebellar diaschisis (CCD) was rarely discussed. In this study, the aim of our study was to assess the performance of ASL-MRI in the detection of crossed cerebellar diaschisis after stroke in compared with single-photon emission CT (SPECT). Results: 17 of 51(33.3%) patients revealed CCD phenomenon by the SPECT method. In CCD-positive group, C BFASL of ipsilateral cerebellar were significantly increased compared with contralateral cerebellar (p 0.001) in the CCD-negative group. Positive correlation was detected between admission National insti‑ tute of health stroke scale (NIHSS) and asymmetry index of SPECT (AISPECT) (r = 0.351, p = 0.011), AIASL (r = 0.372, p = 0.007); infract volume and A ISPECT (r = 0.443, p = 0.001), AIASL (r = 0.426, p = 0.002). Significant correlation was also found between cerebral blood flow of SPECT (CBFSPECT) and CBFASL, AISPECT and AIASL (r = 0.204, p = 0.04; r = 0.467, p = 0.001, respectively). Furthermore, the area under the receiver operating characteristic (ROC) curve value of A IASL was 0.829. Conclusions: CBF derived from ASL-MRI could be valuable for assessment of CCD in supratentorial stroke patients. Additionally, CCD was significantly associated with larger ischemic volume and higher initial NIHSS score. Keywords: Crossed cerebellar diaschisis, Arterial spin-labeling, Single-photon emission CT, Stroke Background Crossed cerebellar diaschisis (CCD), defined as a depression of metabolism and blood flow in the cerebellar hemisphere contralateral to a supratentorial infarct, was first described in 1981 [1]. CCD was consistently reported in several disorders that result in neuronal damage or depletion,, such as status epilepticus [2], supratentorial infarction [3], glioma [4] and lymphoma [5]. Previous studies found that CCD is a secondary neuronal *Correspondence: [email protected] † Juan Wang and Li-Jun Pan contributed to the work equally and should be regarded as co-first authors 1 Department of Radiology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, 1630 Dongfang Rd, Shanghai 200127, China Full list of author information is available at the end of the article
depression which attributed to disruption of the corticoponto-cerebellar pathways with consecutive cerebellar functional inactivation [6]. The previous studies of CCD were frequently reported on single-photon emission CT (SPECT) [7] and positron-emission tomography (PET) [8]. However, the use of radioactive tracers and the high price limit their repeatability and applicatio
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