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Related Experiment Videos

Predicting cerebral ischemic infarct volume with diffusion and perfusion MR imaging.

Pamela W Schaefer1, George J Hunter, Julian He

  • 1Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA. pschaefer@partners.org

AJNR. American Journal of Neuroradiology
|November 13, 2002
PubMed
Summary

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Diffusion-weighted (DW) and perfusion MR imaging effectively detect acute ischemic stroke. DW imaging and cerebral blood volume (CBV) best predict final infarct size, with DW-CBV mismatch indicating lesion growth.

Area of Science:

  • Neuroradiology
  • Neuroimaging
  • Stroke Imaging

Background:

  • Diffusion-weighted (DW) and perfusion magnetic resonance imaging (MRI) are established tools for assessing acute stroke.
  • Evaluating the diagnostic and prognostic utility of these advanced MRI techniques is crucial for stroke management.

Purpose of the Study:

  • To assess the effectiveness of diffusion and perfusion MRI in detecting acute ischemic infarction.
  • To determine the predictive value of these imaging techniques for final infarct volume.

Main Methods:

  • 134 patients with acute ischemic stroke symptoms underwent diffusion-weighted (DW) and perfusion-weighted (PW) imaging within 12.3 hours of symptom onset.
  • Retrospective review of radiology reports for lesion identification on initial DW and PW images.

Related Experiment Videos

  • Comparison of acute lesion volumes with final infarct volumes in 81 patients.

    • Main Results:

    • DW imaging demonstrated high sensitivity (94%) and specificity (96%) for detecting acute infarction.
    • Cerebral blood volume (CBV) showed 100% specificity, while CBF and MTT also had high specificities.
    • DW imaging and CBV exhibited the strongest correlation with final infarct volume (r²=0.9 and r²=0.84, respectively).
    • A diffusion-CBV mismatch predicted lesion growth, unlike diffusion-CBF or diffusion-MTT mismatches.

    Conclusions:

    • Diffusion and hemodynamic MRI are sensitive and specific for acute infarction detection.
    • DW imaging and CBV are superior in predicting final infarct size.
    • DW-CBV mismatch is a valuable indicator of potential lesion expansion.