Reliability of Measuring Lesion Volumes in Transient Ischemic Attack and Minor Stroke

Steffenhagen, Nikolai; Campos, Cynthia Resende; Poppe, Alexandre Y; Khan, Firosh; Kosior, Jayme C.; Demchuk, Andrew M.; Hill, Michael D.; Coutts, Shelagh B.

doi:10.1161/strokeaha.109.570358

Cited by 13 publications

(11 citation statements)

References 6 publications

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“…Quantomo has been previously validated and has good interrater and intrarater agreement. 12 Readers were blinded to all clinical information and follow-up data at the time of scan reading.…”

Section: Imaging Analysesmentioning

confidence: 99%

“…Collateral status by use of the rLMC score (0 -20) was trichotomized into 3 groups: good (17)(18)(19)(20), intermediate (11)(12)(13)(14)(15)(16), and poor (0 -10), according to previously published literature. 3 Differences between these 3 groups were assessed by means of the Fisher exact test for proportions, 1-way ANOVA for parametric data, and a rank sum test for nonparametric data.…”

Section: Statistical Analysesmentioning

confidence: 99%

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CTA Collateral Status and Response to Recanalization in Patients with Acute Ischemic Stroke

Nambiar¹,

Sohn

Almekhlafi

et al. 2013

American Journal of Neuroradiology

148

116

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Section: Imaging Analysesmentioning

confidence: 99%

Section: Statistical Analysesmentioning

confidence: 99%

CTA Collateral Status and Response to Recanalization in Patients with Acute Ischemic Stroke

Nambiar¹,

Sohn

Almekhlafi

et al. 2013

American Journal of Neuroradiology

148

116

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“…We have previously shown a high intra and inter-rater reliability in measurement of small acute DWI and follow-up FLAIR lesions in this population. 27 All images were first reviewed by a neuroradiologist (J.M. ), and all measurements were performed by consensus among 3 investigators (N.A., J.I.C., and J.M.…”

Section: Image Analysismentioning

confidence: 99%

Perfusion MR Predicts Outcome in High-Risk Transient Ischemic Attack/Minor Stroke

Asdaghi

Hill

Coulter

et al. 2013

Stroke

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Multiple groups have shown that the distinction between TIA and minor stroke is arbitrary because they both have identical causes, near-identical prognoses, and the distinction Background and Purpose-Transient or minor ischemic stroke is associated with an early risk of deterioration. Baseline perfusion-diffusion mismatch may predict clinical deterioration and infarct growth in this population. Methods-High-risk transient ischemic attack and minor stroke (National Institutes of Health Stroke Scale ≤3) subjects were prospectively enrolled and imaged with MRI within 24 hours of symptom onset as part of sequential derivation and validation cohorts. Baseline diffusion-weighted imaging, perfusion-weighted imaging (T max ≥4 s), mismatch (T max ≥4 s-diffusion-weighted imaging), and follow-up fluid-attenuated inversion recovery infarct volumes were measured. Primary outcome was infarct growth on fluid-attenuated inversion recovery, and secondary outcome was symptom progression. Results-One hundred thirty-seven and 281 subjects were included in the derivation and validation cohorts, respectively.Infarct growth occurred in 18.5% of the derivation and 5.5% of the validation cohorts. Symptom progression occurred in 9.5% of the derivation and 4.5% of the validation cohorts. In the derivation cohort, subjects with baseline mismatch were significantly more likely to show infarct growth on fluid-attenuated inversion recovery (relative risk [

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“…The DWI lesion volumes are small but comparable to volumes found in acute stroke patients by other groups [27]. A recent study demonstrates excellent inter-rater and intra-rater reliability when measuring small (<5 mL) infarct volumes [28]. One-month FLAIR infarct volume has been found to be highly correlated with, and a good approximation of, final infarct volume [29].…”

Section: Discussionmentioning

confidence: 70%

High Prestroke Physical Activity Is Associated with Reduced Infarct Growth in Acute Ischemic Stroke Patients Treated with Intravenous tPA and Randomized to Remote Ischemic Perconditioning

et al. 2017

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Background: A high prestroke physical activity (PA) level is associated with reduced stroke rate, stroke mortality, better functional outcome, and possible neuroprotective abilities. The aim of the present study was to examine the possible neuroprotective effect of prestroke PA on 24-h cerebral infarct growth in a cohort of acute ischemic stroke patients treated with intravenous tPA and randomized to remote ischemic perconditioning. Methods: In this predefined subanalysis, data from a randomized clinical trial investigating the effect of remote ischemic perconditioning (RIPerC) on AIS was used. Prestroke (7 days before admission) PA was quantified using the PA Scale for the Elderly (PASE) questionnaire at baseline. Infarct growth was evaluated using MRI (acute, 24-h, and 1-month). Results: PASE scores were obtained from 102 of 153 (67%) patients with a median (interquartile range) age of 66 (58-73) years. A high prestroke PA level correlated significantly with reduced acute infarct growth (24 h) in the linear regression model (4th quartile prestroke PA level compared with the 1st quartile), β_{4th quartile} = -0.82 (95% CI -1.54 to -0.10). However, the effect of prestroke PA was present mainly in patients randomized to RIPerC, β_{4th quartile} = -1.14 (95% CI -2.04 to -0.25). In patients randomized to RIPerC, prestroke PA was a predictor of final infarct size (1-month infarct volume), β_{4th quartile} = -1.78 (95% CI -3.15 to -0.41). Conclusion: In AIS patients treated with RIPerC, as add-on to intravenous thrombolysis, the level of PA the week before the stroke was associated with decreased 24-h infarct growth and final infarct size. These results are highly encouraging and stress the need for further exploration of the potentially protective effects of both PA and remote ischemic conditioning.

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Reliability of Measuring Lesion Volumes in Transient Ischemic Attack and Minor Stroke

Cited by 13 publications

References 6 publications

CTA Collateral Status and Response to Recanalization in Patients with Acute Ischemic Stroke

CTA Collateral Status and Response to Recanalization in Patients with Acute Ischemic Stroke

Perfusion MR Predicts Outcome in High-Risk Transient Ischemic Attack/Minor Stroke

High Prestroke Physical Activity Is Associated with Reduced Infarct Growth in Acute Ischemic Stroke Patients Treated with Intravenous tPA and Randomized to Remote Ischemic Perconditioning

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