Document Detail

Prediction of infarct growth based on apparent diffusion coefficients: penumbral assessment without intravenous contrast material.
MedLine Citation:
PMID:  19017923     Owner:  NLM     Status:  MEDLINE    
PURPOSE: To compare predicted and final infarct lesion volumes determined by processing apparent diffusion coefficient (ADC) maps derived at admission diffusion-weighted (DW) magnetic resonance (MR) imaging in patients with acute stroke and to verify that predicted areas of infarct growth reflect at-risk penumbral regions based on recanalization status. MATERIALS AND METHODS: The French legislation waived the requirement for informed patient consent for the described research, which was based on patient medical files. However, patients and/or their relatives were informed that they could decline to participate in the research. Authors tested a semiautomated proprietary image analysis procedure in 98 patients with middle cerebral artery (MCA) stroke by modeling infarct growth on DW imaging-derived ADC maps. Predicted infarct growth (PIG) areas and predicted infarct volumes were correlated with final observed data. In addition, the effect of MCA recanalization on the correlation between predicted and observed infarct growth volumes was qualitatively assessed. RESULTS: Predicted and final infarct volumes (rho = 0.828; 95% confidence interval [CI]: 0.753, 0.882; P < .0001) and infarct growth volumes (rho = 0.506; 95% CI: 0.342, 0.640; P < .0001) were significantly correlated. Visual comparative examination revealed satisfactory qualitative consistency between predicted and follow-up lesion masks. In patients without MCA recanalization, PIG did not differ significantly from final observed infarct growth (median PIG obtained with 0.93 ADC ratio cutoff [PIG(ratio)] of 27.1 cm(3) vs median infarct growth of 19.8 cm(3), P = .17). MCA recanalization revealed an overestimation of PIG (median PIG(ratio) of 24.8 cm(3) vs median infarct growth of 12 cm(3), P = .005), suggesting that the PIG area was part of ischemic penumbra. CONCLUSION: Data show the feasibility of identifying at-risk ischemic tissue in patients with acute MCA stroke by using semiautomated analysis of ADC maps derived at DW imaging, without intravenous contrast material-enhanced perfusion-weighted imaging.
Charlotte Rosso; Nidiyare Hevia-Montiel; Sandrine Deltour; Eric Bardinet; Didier Dormont; Sophie Crozier; Sylvain Baillet; Yves Samson
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2008-11-18
Journal Detail:
Title:  Radiology     Volume:  250     ISSN:  1527-1315     ISO Abbreviation:  Radiology     Publication Date:  2009 Jan 
Date Detail:
Created Date:  2008-12-18     Completed Date:  2009-01-06     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0401260     Medline TA:  Radiology     Country:  United States    
Other Details:
Languages:  eng     Pagination:  184-92     Citation Subset:  AIM; IM    
Copyright Information:
(c) RSNA, 2008.
AP-HP-Urgences Cérébro-Vasculaires, Laboratoire de Neurosciences Cognitives et Imagerie Cérébrale, and AP-HP-Service de Neuroradiologie, Université Pierre et Marie Curie, Paris, France.
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MeSH Terms
Aged, 80 and over
Contrast Media
Diffusion Magnetic Resonance Imaging*
Disease Progression
Feasibility Studies
Follow-Up Studies
Image Processing, Computer-Assisted*
Infarction, Middle Cerebral Artery / diagnosis*
Magnetic Resonance Angiography
Middle Aged
Risk Factors
Reg. No./Substance:
0/Contrast Media

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