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Related Experiment Videos

Fluid-Attenuated Inversion Recovery (FLAIR) Signal Intensity Can Identify Stroke Within 6 and 8 Hours.

John Legge1, Ada Graham1, Shailesh Male2

  • 1College of Medicine, University of Tennessee Health Science Center, Memphis, Tennessee.

Journal of Stroke and Cerebrovascular Diseases : the Official Journal of National Stroke Association
|April 1, 2017
PubMed
Summary

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Magnetic resonance imaging using FLAIR signal intensity ratio (SIR) can accurately identify stroke patients within 6 and 8 hours of symptom onset (SxO). This method aids in determining eligibility for recanalization therapies in wake-up stroke cases.

Area of Science:

  • Neuroimaging
  • Stroke Medicine
  • Radiology

Background:

  • Wake-up or unknown onset stroke patients are often excluded from recanalization therapies.
  • Magnetic resonance imaging (MRI) sequences may help predict stroke onset time.
  • FLAIR signal intensity ratio (SIR) is a potential biomarker for stroke onset estimation.

Purpose of the Study:

  • To evaluate the utility of FLAIR SIR in identifying acute stroke patients within 6 and 8 hours of symptom onset (SxO).
  • To determine the accuracy of FLAIR SIR in predicting early stroke time windows for potential recanalization treatment.

Main Methods:

  • Studied 160 acute stroke patients with known onset times undergoing MRI within 48 hours.
  • Calculated FLAIR SIR by comparing the infarcted area's intensity to the contralateral homologous region.
Keywords:
Brain imagingDWIMRIacute strokeischemic strokestroke onsetthrombectomythrombolysis

Related Experiment Videos

  • Utilized receiver operating characteristic (ROC) curves to assess SIR's predictive performance.

    • Main Results:

    • A positive correlation was found between FLAIR SIR and time from SxO (Pearson's r = 0.63).
    • SIR ≤ 1.18 identified patients within 6 hours (86% sensitivity, 79% specificity).
    • SIR ≤ 1.20 identified patients within 8 hours (89% sensitivity, 76% specificity).
    • 83% of patients with no visible FLAIR hyperintensity were within the 6-hour window.

    Conclusions:

    • Quantitative FLAIR SIR assessment is a valuable tool for identifying stroke patients within 6 and 8 hours of onset.
    • This imaging biomarker can potentially expand recanalization treatment eligibility for unknown onset strokes.
    • FLAIR MRI offers a non-invasive method to estimate stroke onset time, guiding therapeutic decisions.