Relationship between sodium intensity and perfusion deficits in acute ischemic stroke

Adrian Tsang, Robert W. Stobbe, Negar Asdaghi, Muhammad S. Hussain, Yusuf A. Bhagat, Christian Beaulieu, Derek Emery, Ken S. Butcher

Research output: Contribution to journalArticlepeer-review

44 Scopus citations


Purpose To assess the relationship between sodium signal intensity changes and oligemia, measured with perfusion-weighted imaging (PWI), in ischemic stroke patients. Materials and Methods Nine ischemic stroke patients (55 ± 13 years), four with follow-up scans, underwent sodium and proton imaging 4-32 hours after symptom onset. Relative sodium intensity was calculated as the ratio of signal intensities in core (identified as hypertintense lesions on diffusion-weighted imaging [DWI]) or putative penumbra (PWI-DWI mismatch) to contralateral homologous regions. Results Sodium intensity increases in the core were not correlated with the severity of hypoperfusion, measured with either cerebral blood flow (rho = 0.157; P = 0.61) or cerebral blood volume (rho = -0.234; P = 0.44). In contrast, relative sodium intensity was not elevated (4-7 hours 0.96 ± 0.07; 17-32 hours 1.00 ± 0.07) in PWI-DWI mismatch regions. Conclusion Sodium signal intensity cannot be predicted by the degree of hypoperfusion acutely. Sodium intensity also remains unchanged in PWI-DWI mismatch tissue, indicating preservation of ionic homeostasis. Sodium magnetic resonance imaging (MRI), in conjunction with PWI and DWI, may permit identification of patients with viable tissue, despite an unknown symptom onset time.

Original languageEnglish (US)
Pages (from-to)41-47
Number of pages7
JournalJournal of Magnetic Resonance Imaging
Issue number1
StatePublished - Jan 1 2011
Externally publishedYes


  • cerebral ischemia
  • perfusion imaging
  • sodium MRI

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging


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