About acute ischemia,DWI MR provides core infarction area.miss_mach of DWI_PWI can estimates penumbra area.now I want to know for identification penumbra area by just using of PWI, can we use CBV map for determination of core area and then can we identification of penumbra area by miss_mach of CBV_CBF maps?
It is still under debate, IMHO. Clinically, we generally use CBV/CBF maps for identifying penumbra, but I have my doubts on its accuracy; PWI is probably better, especially if you are doing a research project, I highly recommend PWI/DWI
MR derived penumbra has been explored heavily since the development of CBV/CBF/MTT maps in the late 1990s / early 2000s. The original concepts derive more from the PET world, and the OEF / CMRO2 concepts, but this work was also based originally on chronic occlusion patients. MR derived OEF/CMRO2 has also been extensively explored. Unfortunately, despite all of this, it isn't clear that there is an actual "correct" or clinically useful answer. It is my understanding that new data will soon be released as a part of a large trial that provides some insight into which MR derived parameters are useful for defining an imaging penumbra in the acute phase. I would recommend anyone interested in this and related topics to start with the evidence guided review by Dr. Gonzalez at the MGH (http://jnis.bmj.com/content/5/suppl_1/i7).
I would also encourage anyone starting in this field to explore the extensive body of literature, and the more recent discussions about leptomeningeal collaterals.
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