Document Detail


Improved prediction of final infarct volume using bolus delay-corrected perfusion-weighted MRI: implications for the ischemic penumbra.
MedLine Citation:
PMID:  15472086     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND AND PURPOSE: Magnetic resonance imaging (MRI)-based perfusion measures using dynamic susceptibility contrast are extremely useful for identification of ischemic penumbral tissue in acute stroke. However, errors in the measurement of cerebral blood flow (CBF) and mean transit time (MTT) can occur. The aim of this study was to investigate whether bolus delay-corrected (BDC) perfusion measures enable better delineation of the ischemic penumbra. METHODS: Diffusion-weighted MRI (DWI) and perfusion-weighted MRI data were acquired from 19 acute stroke patients. Perfusion abnormalities were manually defined on BDC perfusion maps (corrected MTT [cMTT] and corrected CBF [cCBF]), and on maps derived from an arterial input function placed within the contralateral (CBF, MTT) and ipsilateral (ipsilateral CBF [iCBF] and ipsilateral MTT [iMTT]) middle cerebral artery. Perfusion lesion volumes were correlated with 30-day T2-weighted MRI lesion volumes and with clinical outcome using the National Institutes of Health Stroke Scale (NIHSS). RESULTS: Spearman correlation coefficients for comparing lesion volumes delineated on DWI, CBF, iCBF, cCBF, MTT, iMTT, and cMTT maps with 30-day T2-weighted lesion volumes were 0.72, 0.87, 0.88, 0.90, 0.84, 0.92, and 0.96, respectively (all P<0.001). The analogous correlation coefficients for comparing 30-day National Institutes of Health Stroke Scale (NIHSS) scores were 0.39 (NS), 0.69 (NS), 0.75 (P<0.001), 0.62 (NS), 0.72 (P<0.001), 0.78 (P<0.001), and 0.83 (P<0.001), respectively. CONCLUSIONS: Uncorrected perfusion lesion volumes overestimated the extent of ischemic injury. BDC perfusion measures (cMTT) correlated more accurately with final lesion volume and clinical outcome. Such measures offer an improved estimation of the final infarct size in acute stroke.
Authors:
Stephen E Rose; Andrew L Janke; Mark Griffin; Simon Finnigan; Jonathan B Chalk
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2004-10-07
Journal Detail:
Title:  Stroke; a journal of cerebral circulation     Volume:  35     ISSN:  1524-4628     ISO Abbreviation:  Stroke     Publication Date:  2004 Nov 
Date Detail:
Created Date:  2004-10-29     Completed Date:  2005-05-11     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0235266     Medline TA:  Stroke     Country:  United States    
Other Details:
Languages:  eng     Pagination:  2466-71     Citation Subset:  IM    
Affiliation:
Centre for Magnetic Resonance, University of Queensland 4072, Brisbane, Australia. Stephen.Rose@cmr.uq.edu.au
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MeSH Terms
Descriptor/Qualifier:
Aged
Aged, 80 and over
Brain / blood supply,  pathology
Brain Infarction / diagnosis*
Cerebrovascular Circulation
Diffusion Magnetic Resonance Imaging
Female
Humans
Magnetic Resonance Imaging*
Male
Middle Aged

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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