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Updated: Sep 26, 2026
Brain Infarct Segmentation and Registration on MRI or CT for Lesion-symptom Mapping
Published on: September 25, 2019
Infarct volume on apparent diffusion coefficient maps correlates with length of stay and outcome after middle
Stefan T Engelter1, James M Provenzale, Jeffrey R Petrella
1Department of Radiology, Duke University Medical Center, Durham, NC, USA. sengelter@uhbs.ch
Background:
Diffusion-weighted MRI (DWI) can depict acute ischemia based on decreased apparent diffusion coefficient (ADC) values. ADC maps, unlike DWI (which have contributions from T2 properties), solely reflect diffusion properties. Recent studies indicate that severity of neurological deficit corresponds with degree of ADC alteration.
Purpose:
To determine whether infarct volume on ADC maps correlates with length of hospitalization and clinical outcome in patients with acute ischemic middle cerebral artery (MCA) stroke.
Study Population:
Forty-five consecutive patients with acute (
Methods:
Infarct volume was determined by counting pixels with ADC values >3 SDs below the average ADC value of a contralateral control region. Infarct volume was correlated with length of hospitalization and 6-month outcome assessed with Glasgow Outcome Scale (GOS), Modified Rankin Score (mRS), Barthel Index (BI) and a dichotomized outcome status with favorable outcome defined as GOS 1, mRS
Results:
Infarct volume on ADC maps ranged from 0.2 to 187 cm(3) and was significantly correlated with length of hospitalization (p < 0.001, r = 0.67). Furthermore, ADC infarct volume was significantly correlated with GOS (r = 0.73), mRS (r = 0.68), BI (r = 0.67) and outcome status (r = 0.65) (each p < 0.001). Multiple logistic regression revealed a statistically significant correlation between ADC infarct volume and outcome status (p < 0.05), but none for Canadian Neurological Scale score, age and gender (p >0.05 each).
Conclusion:
Infarct volume measured by using a quantitative definition for infarcted tissue on ADC maps correlated significantly with length of hospitalization (as a possible surrogate marker for short-term outcome) and functional outcome after 6 months. ADC infarct volume may provide prognostic information for patients with acute ischemic MCA stroke.
Insights
Infarct volume on apparent diffusion coefficient (ADC) maps significantly correlates with hospitalization length and 6-month outcomes in acute ischemic stroke patients. This quantitative ADC infarct volume offers prognostic value for middle cerebral artery strokes.
Area of Science:
- Neuroimaging
- Radiology
- Stroke Medicine
Background:
- Diffusion-weighted MRI (DWI) detects acute ischemia via decreased apparent diffusion coefficient (ADC) values.
- ADC maps isolate diffusion properties, unlike DWI which includes T2 effects.
- Neurological deficit severity correlates with ADC alteration extent.
Purpose of the Study:
- To assess the correlation between infarct volume on ADC maps and hospitalization duration.
- To evaluate the relationship between ADC infarct volume and 6-month clinical outcomes in acute middle cerebral artery (MCA) stroke.
Main Methods:
- Analyzed 45 patients with acute MCA infarcts (<72h) using DWI.
- Quantified infarct volume by counting pixels with ADC values >3 SDs below contralateral control regions.
- Correlated ADC infarct volume with hospitalization length and functional outcomes (GOS, mRS, BI).
Main Results:
- ADC infarct volume ranged from 0.2 to 187 cm³.
- Significant correlations found between ADC infarct volume and hospitalization length (r=0.67, p<0.001).
- ADC infarct volume strongly correlated with 6-month outcomes: GOS (r=0.73), mRS (r=0.68), BI (r=0.67), and outcome status (r=0.65), all p<0.001.
Conclusions:
- Quantitative ADC infarct volume is a significant predictor of hospitalization duration and 6-month functional outcomes in acute ischemic MCA stroke.
- ADC infarct volume provides valuable prognostic information for stroke patients.
- ADC mapping offers a reliable method for assessing infarct size and predicting outcomes.
