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Updated: Apr 10, 2026
Brain Infarct Segmentation and Registration on MRI or CT for Lesion-symptom Mapping
Published on: September 25, 2019
Dynamic Evolution of Diffusion-Weighted Imaging Lesions in Patients With Minor Ischemic Stroke
Mahesh P Kate1, Parnian Riaz1, Laura Gioia1
1From the Division of Neurology, Department of Medicine (M.P.K., P.R., L.G., L.S., T.J., B.B., K.B.) and Department of Biomedical Engineering (C.B.), University of Alberta, Edmonton, Canada.
Background And Purpose:
Diffusion-weighted imaging (DWI) lesion volume on magnetic resonance imaging is increasingly being used as a surrogate outcome measure in clinical trials. We aimed to characterize the evolution of DWI lesion volumes within 30 days of symptom onset after minor stroke.
Methods:
Minor stroke patients with DWI lesions on magnetic resonance imaging within 48 hours of symptom onset were prospectively followed with magnetic resonance imaging brain scan at 7 and 30 days. Change in the lesion volume was defined as the difference between day 30 Fluid-Attenuated Inversion Recovery and baseline DWI lesion volumes.
Results:
Three patterns of infarct evolution were observed: reduction (72 [63%]), no change (26 [23%]), and growth (16 [14%]). Patients with infarct reduction at 30 days had larger baseline DWI lesion volumes (2.5 [0.9-8.5] mL) than those with stable infarcts (0.5 [0.3-0.9] mL; P=0.01). Complete DWI reversal at day 30, was seen in only 6 (5.3%) patients.
Conclusions:
The most common pattern of infarct evolution in patients with minor stroke is a reduction in volume, but complete resolution is uncommon.
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