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Updated: Jun 24, 2026
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A Magnetic Resonance Imaging Protocol for Stroke Onset Time Estimation in Permanent Cerebral Ischemia
Published on: September 16, 2017
Quantitative t2 values predict time from symptom onset in acute stroke patients
Susanne Siemonsen1, Kim Mouridsen, Brigitte Holst
1Department of Neuroradiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany. s.siemonsen@uke.uni-hamburg.de
Stroke
|March 28, 2009
Summary
Quantitative T2 values correlate well with time from stroke onset, offering a more reproducible method than diffusion-weighted imaging for assessing water uptake in ischemic tissue.
Area of Science:
- Neuroimaging
- Stroke Imaging
- Quantitative MRI
Background:
- Diffusion-weighted imaging (DWI) is standard for acute ischemic stroke.
- Quantitative T2 (qT2) values may better reflect water uptake, a key process in ischemic tissue.
- Time from symptom onset is critical for acute stroke treatment decisions.
Purpose of the Study:
- To compare the correlation of qT2 values with time from symptom onset against diffusion-weighted imaging.
- To assess the utility of qT2 in quantifying water uptake in the infarct core.
- To evaluate the accuracy of qT2 in predicting early time windows (<3 hours) post-stroke.
Main Methods:
- 36 acute ischemic stroke patients underwent MRI (DWI, FLAIR, T2 mapping) within 6 hours of onset.
- Infarct core regions (low ADC) were identified and compared with unaffected tissue on T2 maps.
- Differences in T2 and apparent diffusion coefficient (ADC) values were calculated; FLAIR lesion visibility was also assessed.
Main Results:
- Differences in T2 values showed a significant correlation with time from symptom onset (R=0.580, P<0.001).
- T2 values were significantly higher in patients with visible FLAIR lesions (P<0.001).
- qT2 accuracy for predicting <3 hours from onset was 0.794, outperforming visual FLAIR assessment (0.676).
Conclusions:
- qT2 values correlate strongly with time from stroke onset, indicating pathophysiological changes beyond diffusion restriction.
- qT2 offers a reproducible, quantitative measure of time from onset, superior to the binary information from FLAIR.
- qT2 mapping may improve clinical decision-making in acute ischemic stroke management.
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