RT Journal Article SR Electronic T1 Crossed Cerebellar Diaschisis in Acute Stroke Detected by Dynamic Susceptibility Contrast MR Perfusion Imaging JF American Journal of Neuroradiology JO Am. J. Neuroradiol. FD American Society of Neuroradiology SP 710 OP 715 DO 10.3174/ajnr.A1435 VO 30 IS 4 A1 D.D.M. Lin A1 J.T. Kleinman A1 R.J. Wityk A1 R.F. Gottesman A1 A.E. Hillis A1 A.W. Lee A1 P.B. Barker YR 2009 UL http://www.ajnr.org/content/30/4/710.abstract AB 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, MR perfusion may be a viable alternative to PET or SPECT to study the phenomenon and clinical consequences of supratentorial stroke with CCD.