Viability Thresholds of Ischemic Penumbra of Hyperacute Stroke Defined by Perfusion-Weighted MRI and Apparent Diffusion Coefficient
| Autor: | Claus Z Simonsen, Grethe Andersen, Masaharu Sakoh, Lisbeth Røhl, Carsten Gyldensted, Peter Vestergaard-Poulsen, Leif Østergaard, D. Le Bihan |
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| Přispěvatelé: | Department of Molecular Biology, University of Aarhus, Service NEUROSPIN (NEUROSPIN), Direction de Recherche Fondamentale (CEA) (DRF (CEA)), Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Université Paris-Saclay, IFR de Neuroimagerie Fonctionnelle (IFR 49), Commissariat à l'énergie atomique et aux énergies alternatives (CEA), Service Hospitalier Frédéric Joliot (SHFJ), Université Paris-Saclay-Direction de Recherche Fondamentale (CEA) (DRF (CEA)), Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Commissariat à l'énergie atomique et aux énergies alternatives (CEA), Le Bihan, Denis |
| Rok vydání: | 2001 |
| Předmět: |
Male
Pathology [SDV.IB.IMA]Life Sciences [q-bio]/Bioengineering/Imaging Infarction Severity of Illness Index Brain Ischemia MESH: Magnetic Resonance Imaging 030218 nuclear medicine & medical imaging Diffusion MESH: Aged 80 and over 0302 clinical medicine Stroke Aged 80 and over MESH: Aged MESH: Middle Aged Penumbra Brain Discriminant Analysis MESH: Brain Ischemia MESH: Diffusion MESH: Blood Flow Velocity MESH: Cerebrovascular Circulation Middle Aged Magnetic Resonance Imaging MESH: Predictive Value of Tests Perfusion MESH: Cell Survival Cerebral blood flow Cerebrovascular Circulation Acute Disease Disease Progression MESH: Acute Disease Female MESH: Disease Progression MESH: Tomography X-Ray Computed Cardiology and Cardiovascular Medicine Blood Flow Velocity MESH: Perfusion Adult medicine.medical_specialty Cell Survival Ischemia Sensitivity and Specificity MESH: Stroke Central nervous system disease MESH: Brain 03 medical and health sciences Predictive Value of Tests MESH: Severity of Illness Index medicine Humans Effective diffusion coefficient cardiovascular diseases Aged Advanced and Specialized Nursing MESH: Humans business.industry MESH: Discriminant Analysis MESH: Adult MESH: ROC Curve medicine.disease MESH: Male MESH: Sensitivity and Specificity [SDV.IB.IMA] Life Sciences [q-bio]/Bioengineering/Imaging ROC Curve Neurology (clinical) Tomography X-Ray Computed Nuclear medicine business MESH: Female 030217 neurology & neurosurgery |
| Zdroj: | Stroke Stroke, American Heart Association, 2001, 32 (5), pp.1140-6 Stroke, 2001, 32 (5), pp.1140-6 Røhl, L, Østergaard, L, Simonsen, C Z, Vestergaard-Poulsen, P, Andersen, G, Sakoh, M, Le Bihan, D & Gyldensted, C 2001, ' Viability thresholds of ischemic penumbra of hyperacute stroke defined by perfusion-weighted MRI and apparent diffusion coefficient ', Stroke, vol. 32, pp. 1140-1146 . https://doi.org/10.1161/01.STR.32.5.1140 ResearcherID |
| ISSN: | 1524-4628 0039-2499 |
| DOI: | 10.1161/01.str.32.5.1140 |
| Popis: | Background and Purpose —The penumbra of ischemic stroke consists of hypoperfused, but not irreversibly damaged, tissue surrounding the ischemic core. The purpose of this study was to determine viability thresholds in the ischemic penumbra, defined as the perfusion/diffusion mismatch in hyperacute stroke, by the use of diffusion- and perfusion-weighted MRI (DWI and PWI, respectively). Methods —DWI and PWI were performed in 11 patients ≤6 hours after the onset of symptoms of acute ischemic stroke. Regions of interest (ROIs) were placed covering the ischemic core (ROI 1), the penumbra that progressed to infarction on the basis of follow-up scans (ROI 2), and the penumbra that recovered (ROI 3). The ratios of relative cerebral blood flow (rCBF), relative cerebral blood volume (rCBV), mean transit time (MTT), and apparent diffusion coefficient were calculated as lesion ROIs relative to the contralateral mirror ROIs. Results —The post hoc analysis showed that the penumbra progressed to infarction at the following cutoff values: rCBF 1.63. Higher sensitivity and accuracy in predicting outcome of the penumbra were obtained from the rCBF maps compared with the rCBV and MTT maps. The initial rCBV and apparent diffusion coefficient ratios did not differentiate between the part of the penumbra that recovered and the part that progressed to infarction. The mean rCBF ratio was optimal in distinguishing the parts of the penumbra recovering or progressing to infarction. Conclusions —The thresholds found in this study by combined DWI/PWI might aid in the selection of patients suitable for therapeutic intervention within 6 hours. However, these hypothesized thresholds need to be prospectively tested at the voxel level on a larger patient sample before they can be applied clinically. |
| Databáze: | OpenAIRE |
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