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Related Concept Videos

Assessment of Diffusion and Perfusion01:17

Assessment of Diffusion and Perfusion

Understanding and evaluating diffusion and perfusion is critical in assessing a patient's respiratory and circulatory health. These processes play key roles in maintaining the body's internal environment, ensuring that tissues receive adequate oxygen while waste products are efficiently removed.
The Role of Diffusion in Respiration
Diffusion is the process by which molecules move from an area of higher concentration to an area of lower concentration. In the respiratory system, this principle...

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Magnetic Resonance Imaging Quantification of Pulmonary Perfusion using Calibrated Arterial Spin Labeling
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Published on: May 30, 2011

Rapid assessment of perfusion-diffusion mismatch.

Ken Butcher1, Mark Parsons, Louise Allport

  • 1Department of Neurology, Royal Melbourne Hospital, University of Melbourne, Melbourne, Australia. ken.butcher@ualberta.ca

Stroke
|December 8, 2007
PubMed
Summary

MR mismatch scores offer a rapid and reliable tool for selecting thrombolysis patients. This method reduces variability in perfusion-diffusion weighted imaging (PWI-DWI) assessments, improving stroke treatment decisions.

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Area of Science:

  • Neuroimaging
  • Stroke Imaging
  • Radiology

Background:

  • Accurate assessment of perfusion-diffusion weighted imaging (PWI-DWI) mismatch is crucial for selecting stroke patients for thrombolysis.
  • Current volumetric measurements of PWI-DWI mismatch exhibit significant interrater variability, hindering routine clinical application.

Purpose of the Study:

  • To examine interrater variability in PWI-DWI volume measurements.
  • To develop and validate a rapid assessment tool for PWI-DWI mismatch using the Alberta Stroke Program Early CT Scores (ASPECTS) system.

Main Methods:

  • 35 stroke patients (<6 hours onset) underwent DWI and PWI.
  • Volumetric measurements were performed planimetrically by four raters.
  • ASPECT scores were assessed for DWI and PWI, and MR mismatch scores were calculated.

Main Results:

  • Interobserver variability was significantly higher for PWI (95% LOA +/-72.3 mL) than DWI (95% LOA +/-12.6 mL).
  • A semiautomated PWI volume calculation improved mismatch assessment.
  • MR mismatch scores demonstrated high sensitivity (78%) and specificity (88%) for predicting 20% PWI-DWI mismatch.
  • Excellent agreement (kappa=0.94) was observed between experienced raters using MR mismatch scores.

Conclusions:

  • Variability in planimetric mismatch measurement is mainly due to PWI volume assessment differences.
  • MR mismatch scores exhibit high specificity and interrater reliability.
  • MR mismatch scores are a promising rapid screening tool for identifying potential thrombolysis candidates.