Related Experiment Video
Updated: Apr 20, 2026
Brain Infarct Segmentation and Registration on MRI or CT for Lesion-symptom Mapping
Published on: September 25, 2019
Final infarct volume estimation on 1-week follow-up MR imaging is feasible and is dependent on recanalization status
Mark Krongold1, Mohammed A Almekhlafi2, Andrew M Demchuk3
1Radiology and Clinical Neurosciences, Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada ; Seaman Family Centre, Foothills Medical Centre, Alberta Health Services, Calgary, Alberta, Canada ; Biomedical Engineering, University of Calgary, Calgary, Alberta, Canada.
Purpose:
We aim to characterize infarct volume evolution within the first month post-ischemic stroke and to determine the effect of recanalization status on early infarct volume estimation.
Methods:
Ischemic stroke patients recruited for the MONITOR and VISION studies were retrospectively screened and patients who had infarcts on diffusion-weighted imaging (DWI) at baseline and had at least two follow-up MR scans (n = 56) were included. Pre-defined target imaging time points, obtained on a 3-T MR scanner, were 12 hours (h), 24 h, 7 days, and ≥30 days post-stroke. Infarct tissue was manually traced blinded to the images at the other time points. Infarct expansion index was calculated by dividing infarct volume at each follow-up time point by the baseline DWI infarct volume. Recanalization was assessed within 24 h post-stroke. Correlation and statistical comparison analysis were done using the Spearman, Mann-Whitney, and Kruskal-Wallis tests.
Results:
Follow-up infarct volumes were positively correlated with the baseline infarct volume (ρ > 0.81; p < 0.001) where the strongest correlation existed between baseline and 7-day post-stroke infarct volumes (ρ = 0.92; p < 0.001). The strongest correlation among the follow-up imaging was found between infarct volumes 7-day post-stroke and ≥30-day time points (ρ = 0.93; p < 0.001). Linear regression showed a close-to unity slope between 7-day and final infarct volumes (slope = 1.043; p < 0.001). Infarct expansion was higher in the non-recanalized group than the recanalized group at the 7-day (p = 0.001) and ≥30-day (p = 0.038) time points.
Conclusions:
Final infarct volume can be approximated as early as 7 days post-stroke. Final infarct volume approximation is significantly associated with recanalization status.
