Abstract
The remarkable temperature sensitivity of the brain is widely recognized and has been studied for its role in the potentiation of ischemic and other neurologic injuries. Pyrexia frequently complicates large-vessel acute ischemic stroke and develops commonly in critically ill neurologic patients; the profound sensitivity of the brain even to minor intraischemic temperature changes, together with the discovery of brain-to-systemic as well as intracerebral temperature gradients, has thus compelled the exploration of cerebral thermoregulation and uncovered its immutable dependence on cerebral blood flow. A lack of pragmatic and noninvasive tools for spatially and temporally resolved brain thermometry has historically restricted empiric study of cerebral temperature homeostasis; however, MR thermometry (MRT) leveraging temperature-sensitive nuclear magnetic resonance phenomena is well-suited to bridging this long-standing gap. This review aims to introduce the reader to the following: 1) fundamental aspects of cerebral thermoregulation, 2) the physical basis of noninvasive MRT, and 3) the physiologic interdependence of cerebral temperature, perfusion, metabolism, and viability.
Highlights
We previously reported on the tendency for greater consumption of penumbral tissues in fully reperfused patients with acute ischemic stroke when fevers exceeded 37.5°C in the early stroke aftermath
Using robust adiabatic multivoxel chemical shift imaging strategies with greater performance against chemical shift misregistration, together with higher order magnetic field shimming, we recently reported on dynamic brain temperature changes following highly-controlled endovascular stroke induction in NHP.[41]
MR thermometry has found broad applications in the real-time monitoring of thermal therapies, and despite obvious differences from the preceding sections, for completeness, we introduce the reader to this emergent application of cerebral thermometry
Summary
Body temperature is tightly controlled in humans at approximately 37°C and regulated through the balance of heat-conserving and heat-dissipating mechanisms mediated by the hypothalamus.[6]. 556 Dehkharghani Apr 2020 www.ajnr.org temperature homeostasis has been established through numeric simulations often based in the seminal bioheat equations proposed by Pennes (1948),[42] and the reader is referred to excellent resources on the topic.[8,9,10,43,44,45,46,47]
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