Diffusion-weighted imaging volume and diffusion-weighted imaging volume growth in acute stroke

Zhou, Shi-Bo; Zhang, Xiuming; Gao, Yang; Yang, Bo; Shen, Wenrong

doi:10.1097/wnr.0000000000001291

Cited by 5 publications

(2 citation statements)

References 33 publications

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“…Our finding is consistent with those in previous studies reporting that patients with an FVH-DWI mismatch have higher ASITN/SIR scores, ie, better collaterals than those without an FVH-DWI mismatch. 34,35 These studies, however, considered the FVH-DWI mismatch as a binary variable compared with an ordinal one as used here. Samples used were small and overlapping, and interobserver reproducibility of collateral assessment on DSA was lacking.…”

Section: Discussionmentioning

confidence: 99%

FLAIR Vascular Hyperintensities as a Surrogate of Collaterals in Acute Stroke: DWI Matters

Legrand¹,

Berre²,

Seners³

et al. 2022

AJNR Am J Neuroradiol

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BACKGROUND AND PURPOSE: FLAIR vascular hyperintensities are thought to represent leptomeningeal collaterals in acute ischemic stroke. However, whether all-FLAIR vascular hyperintensities or FLAIR vascular hyperintensities-DWI mismatch, ie, FLAIR vascular hyperintensities beyond the DWI lesion, best reflects collaterals remains debated. We aimed to compare the value of FLAIR vascular hyperintensities-DWI mismatch versus all-FLAIR vascular hyperintensities for collateral assessment using PWI-derived collateral flow maps as a reference. MATERIALS AND METHODS:We retrospectively reviewed the registries of 6 large stroke centers and included all patients with acute stroke with anterior circulation large-vessel occlusion who underwent MR imaging with PWI before thrombectomy. Collateral status was graded from 1 to 4 on PWI-derived collateral flow maps and dichotomized into good (grades 3-4) and poor (grades 1-2). The extent of all-FLAIR vascular hyperintensities and FLAIR vascular hyperintensities-DWI mismatch was assessed on the 7 cortical ASPECTS regions, ranging from 0 (absence) to 7 (extensive), and associations with good collaterals were compared using receiver operating characteristic curves. RESULTS:Of the 209 included patients, 133 (64%) and 76 (36%) had good and poor collaterals, respectively. All-FLAIR vascular hyperintensity extent was similar between collateral groups (P ¼ .76). Conversely, FLAIR vascular hyperintensities-DWI mismatch extent was significantly higher in patients with good compared with poor collaterals (P , .001). The area under the curve was 0.80 (95% CI, 0.74-0.87) for FLAIR vascular hyperintensities-DWI mismatch and 0.52 (95% CI, 0.44-0.60) for all-FLAIR vascular hyperintensities (P , .001 for the comparison), to predict good collaterals. Variables independently associated with good collaterals were smaller DWI lesion volume (P , .001) and larger FLAIR vascular hyperintensities-DWI mismatch (P ¼ .02). CONCLUSIONS:In acute ischemic stroke with large-vessel occlusion, the extent of FLAIR vascular hyperintensities does not reliably reflect collateral status unless one accounts for DWI.

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Section: Discussionmentioning

confidence: 99%

FLAIR Vascular Hyperintensities as a Surrogate of Collaterals in Acute Stroke: DWI Matters

Legrand¹,

Berre²,

Seners³

et al. 2022

AJNR Am J Neuroradiol

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“…Thus, it is recommendable to combine DWI with other techniques like PWI for assessing perfusion and metabolism to understand the pathophysiology of ischemic stroke. DWI also aids in predicting functional outcomes after thrombectomy in acute stroke patients (Zhou et al, 2019). By offering accurate image representation and reliable quantitative measurements, DWI provides crucial information for early diagnosis, functional assessment, and prognosis prediction (Khang & Shah et al, 2023).…”

Section: Diffusion-weighted Imagingmentioning

confidence: 99%

Applications of Magnetic Resonance Imaging in Stroke for Multidimensional Assessment

Wang,

Liu

2023

AI and IoT-Based Technologies for Precision Medicine

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Stroke remains a leading cause of disability and death worldwide. Accurate diagnosis of stroke is vital for guiding treatment decisions and predicting outcomes. Different types of strokes have distinct pathological processes, but they share many common symptoms with other brain disorders. Differential diagnosis of stroke is important but challenging; with non-invasive nature, diverse sequences, and high spatiotemporal resolution, it enables multidimensional assessment of stroke. It can detect hemodynamic and structural changes in intracranial arteries, and the metabolic state of relevant brain regions. MRI can differentiate between ischemic stroke, hemorrhagic stroke, and other intracranial vascular lesions. To improve diagnostic accuracy, numerous methods and algorithms have been proposed towards precise diagnosis. This chapter first briefly introduces the concept of structural MRI and its role in precise diagnosis of stroke.

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The impact of FLAIR vascular hyperintensity on clinical severity and outcome

Huang

2020

Neurol Sci

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Diffusion-weighted imaging volume and diffusion-weighted imaging volume growth in acute stroke

Cited by 5 publications

References 33 publications

FLAIR Vascular Hyperintensities as a Surrogate of Collaterals in Acute Stroke: DWI Matters

FLAIR Vascular Hyperintensities as a Surrogate of Collaterals in Acute Stroke: DWI Matters

Applications of Magnetic Resonance Imaging in Stroke for Multidimensional Assessment

The impact of FLAIR vascular hyperintensity on clinical severity and outcome

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