Arterial Spin Labeling Magnetic Resonance Imaging for Differentiating Acute Ischemic Stroke from Epileptic Disorders
| Autor: | Hiroaki Ooboshi, Sei Haga, Yuka Kanazawa, Noriko Hagiwara, Takato Morioka, Takafumi Shimogawa, Tetsuro Ago, Takanari Kitazono, Shuji Arakawa |
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| Rok vydání: | 2018 |
| Předmět: |
Male
medicine.medical_specialty Magnetic resonance angiography Brain Ischemia Diagnosis Differential 03 medical and health sciences Epilepsy 0302 clinical medicine Predictive Value of Tests otorhinolaryngologic diseases Medicine Humans cardiovascular diseases Aged Retrospective Studies Aged 80 and over medicine.diagnostic_test business.industry Arterial Spin Labeling Magnetic Resonance Imaging Rehabilitation Brain Reproducibility of Results Magnetic resonance imaging Emergency department Middle Aged medicine.disease Hyperintensity Stroke medicine.anatomical_structure Diffusion Magnetic Resonance Imaging Surgery Female Spin Labels Neurology (clinical) Radiology Differential diagnosis Cardiology and Cardiovascular Medicine business 030217 neurology & neurosurgery Artery |
| Zdroj: | Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association. 28(6) |
| ISSN: | 1532-8511 |
| Popis: | Background Differential diagnosis between acute ischemic stroke (AIS) and epilepsy-related stroke mimics is sometimes difficult in the emergency department. We investigated whether a combination of diffusion-weighted imaging (DWI) and arterial spin labeling imaging (ASL) is useful in distinguishing AIS from epileptic disorders. Methods The study included suspected AIS patients who underwent emergency MRI including both DWI and ASL, and who exhibited DWI high-intensity lesions corresponding to neurological symptoms. We investigated the relationship between the ASL results from within and/or around DWI lesions and the final clinical diagnosis. Results Eighty-five cases were included (mean age, 71 ± 13 years; 47 men). The time from onset to the MRI examination was 493 ± 536 minutes. ASL showed hyperintensity in 13 patients, isointensity in 43, and hypointensity in 29. All ASL hyperintensities were observed in the cortex, with 4 patients (31%) presenting with AIS and 9 (69%) with an epileptic disorder. All of the AIS patients with ASL hyperintensity were diagnosed with cardioembolic stroke (4/4, 100%), with magnetic resonance angiography demonstrating recanalization of the occluded artery in all cases (4/4, 100%). In the 9 patients with an epileptic disorder, the area of ASL hyperintensity typically extended beyond the vascular territory (7/9, 78%) and involved the ipsilateral thalamus (7/9, 78%). All patients with ASL isointensity and hypointensity were diagnosed with AIS; none had epileptic disorders. Conclusions Although cortical ASL hyperintensity can indicate cardioembolic stroke with recanalization, hyperintensity beyond the vascular territory may alternatively suggest an epileptic disorder in suspected AIS patients with DWI lesions. |
| Databáze: | OpenAIRE |
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