APT-weighted (APTw) imaging based on MTR asymmetry analysis has shown promise for identifying ischemic lesions, but suffers from low accuracy due to small APTw intensity changes, Quantitative APT, nuclear overhauser enhancement (NOE), perfusion and diffusion MRI were performed on acute stroke patients (n=30). The results showed that while APTw MRI for pH analysis based on MTRasym analysis was confounded by upfield NOE effects, NOE-free APT-MRI contrast between normal and ischemic lesions was substantially increased, nearly 3 times larger than that based on MTRasym analysis. Furthermore, noticeable NOE contrast was observed for lesions, explained in terms of a relayed-NOE transfer mechanism.
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