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Titolo:
Viability thresholds of ischemic penumbra of hyperacute stroke defined by perfusion-weighted MRI and apparent diffusion coefficient
Autore:
Rohl, L; Ostergaard, L; Simonsen, CZ; Vestergaard-Poulsen, P; Andersen, G; Sakoh, M; Le Bihan, D; Gyldensted, C;
Indirizzi:
Aarhus Univ Hosp, Dept Neuroradiol, DK-8000 Aarhus C, Denmark Aarhus Univ Hosp Aarhus Denmark C Neuroradiol, DK-8000 Aarhus C, Denmark Aarhus Univ Hosp, Dept Neurol, DK-8000 Aarhus, Denmark Aarhus Univ Hosp Aarhus Denmark DK-8000 Neurol, DK-8000 Aarhus, Denmark Ehime Univ, Dept Neurosurg, Matsuyama, Ehime 790, Japan Ehime Univ Matsuyama Ehime Japan 790 urosurg, Matsuyama, Ehime 790, Japan CEA, Serv Hosp Frederic Joliot, F-91406 Orsay, France CEA Orsay France F-91406 erv Hosp Frederic Joliot, F-91406 Orsay, France
Titolo Testata:
STROKE
fascicolo: 5, volume: 32, anno: 2001,
pagine: 1140 - 1146
SICI:
0039-2499(200105)32:5<1140:VTOIPO>2.0.ZU;2-K
Fonte:
ISI
Lingua:
ENG
Soggetto:
CEREBRAL BLOOD-FLOW; POSITRON-EMISSION-TOMOGRAPHY; HIGH-RESOLUTION MEASUREMENT; CAROTID-ARTERY OCCLUSION; LOCAL BRAIN HEMODYNAMICS; TRACER BOLUS PASSAGES; MAGNETIC-RESONANCE; CEREBROVASCULAR-DISEASE; OXYGEN-METABOLISM; FOCAL ISCHEMIA;
Keywords:
MRI, diffusion-weighted; MRI, perfusion-weighted; penumbra; stroke, acute;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
47
Recensione:
Indirizzi per estratti:
Indirizzo: Rohl, L Aarhus Univ Hosp, Dept Neuroradiol, Norrebrogade 44, DK-8000 Aarhus C, Denmark Aarhus Univ Hosp Norrebrogade 44 Aarhus Denmark C rhus C, Denmark
Citazione:
L. Rohl et al., "Viability thresholds of ischemic penumbra of hyperacute stroke defined by perfusion-weighted MRI and apparent diffusion coefficient", STROKE, 32(5), 2001, pp. 1140-1146

Abstract

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 less than or equal to6 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 thepenumbra 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 <0.59 and MTT >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.

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Documento generato il 25/01/20 alle ore 03:26:02