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Updated: Apr 5, 2026
A Magnetic Resonance Imaging Protocol for Stroke Onset Time Estimation in Permanent Cerebral Ischemia
Published on: September 16, 2017
Predicting Collateral Status With Magnetic Resonance Perfusion Parameters: Probabilistic Approach With a Tmax-Derived
Mi Ji Lee1, Jeong Pyo Son1, Suk Jae Kim1
1From the Departments of Neurology (M.J.L., S.J.K., S.R., G.-M.K., C.-S.C., K.H.L., O.Y.B.) and Radiology (J.C.), Samsung Medical Center, School of Medicine (M.J.L., S.J.K., S.R., G.-M.K., C.-S.C., K.H.L., O.Y.B., J.C.) and Department of Health Sciences and Technology, Samsung Advanced Institute for Health Sciences and Technology (J.P.S., O.Y.B.), Sungkyunkwan University, Seoul, Korea; and Biostatistics Team, Samsung Biomedical Research Institute, Seoul, Korea (S.-Y.W.).
Magnetic resonance perfusion imaging (MRP) can predict good collateral flow in acute ischemic stroke patients. Severe Tmax delays identified by MRP correlate with poor collaterals and predict infarct growth.
Area of Science:
- Neurology
- Radiology
- Medical Imaging
Background:
- Good collateral circulation is vital for successful acute ischemic stroke treatment.
- Magnetic resonance perfusion-weighted imaging (MRP) is a key tool in stroke assessment.
- Predicting collateral status using MRP parameters remains an area of investigation.
Purpose of the Study:
- To investigate the relationship between hypoperfusion severity and collateral status in acute ischemic stroke.
- To develop a predictive model for good collaterals using MRP parameters.
Main Methods:
- Patients undergoing serial diffusion-weighted imaging and MRP were analyzed.
- Collateral flow maps were generated from MRP data using automatic postprocessing.
- Hypoperfusion severity, defined by Tmax delay strata, was compared between good and poor collateral groups.
Main Results:
- 53 out of 66 patients exhibited good collaterals.
- Severe Tmax delays (Tmax > 16s) were significantly associated with poor collaterals.
- A Tmax severity-weighted model showed high predictive power (AUC=0.9303) for good collaterals.
- The predictive score negatively correlated with infarct growth.
Conclusions:
- Collateral status in acute ischemic stroke is linked to more pronounced Tmax delays than previously recognized.
- The developed Tmax severity-weighted model effectively identifies good collaterals and predicts subsequent infarct growth.
