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British Journal of Anaesthesia, 2002, Vol. 89, No. 4 605-613
© 2002 The Board of Management and Trustees of the British Journal of Anaesthesia

Laboratory Investigations

Apparent diffusion coefficient mapping predicts mortality and outcome in rats with intracerebral haemodynamic disturbance: potential role of intraoperative diffusion and perfusion weighted magnetic resonance imaging to detect cerebral ischaemia

S. Ishikawa*,1, K. Yokoyama1, T. Kuroiwa2 and K. Makita1

1 Department of Anesthesiology and Critical Care Medicine and 2 Department of Neuropathology, Medical Research Institute, Tokyo Medical and Dental University, School of Medicine, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8519, Japan*Corresponding author

Background. Usefulness and ability of diffusion and perfusion weighted magnetic resonance images (DWI and PWI) to detect intracerebral haemodynamic disturbance have not been fully evaluated.

Methods. After the right common carotid artery had been ligated, rats were exsanguinated to maintain a mean arterial pressure of 35, 42, or 50 mm Hg (n=6, each group). Apparent diffusion coefficient (ADC) maps were calculated from DWIs and lesion volume (area) was defined based on ADC values (ADC lesion volume (area)).

Results. ADC lesion volume during exsanguination in the 35 mm Hg group (417 (111) mm3, P<0.01) was significantly larger than in the 42 mm Hg group (87 (84) mm3) and 50 mm Hg group (42 (58) mm3). The low relative cerebral blood flow area, calculated from PWI, was significantly larger during exsanguination in the 35 mm Hg group than in the other groups. ADC lesion volume in the six rats that died within 3 days of the MRI study was significantly larger (median 421 mm3, range 205–476 mm3, P<0.005) than in the 12 rats that survived for 3 days (median 26 mm3, range 3–517 mm3). Rats with an ADC lesion area over 14 mm2 on the coronal slice including the caudate putamen during exsanguination died within 3 days or revealed a more severe histopathological outcome than those that survived for 3 days.

Conclusions. Incomplete cerebral ischaemia created by the combination of common carotid artery occlusion and exsanguination could be detected by DWI and PWI both qualitatively and quantitatively. The size of the lesion on ADC mapping was found to correlate with mortality and outcome.

Br J Anaesth 2002; 89: 605–13


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