Diffusion-weighted MR Imaging: Diagnostic Accuracy in Patients Imaged within 6 Hours of Stroke Symptom Onset

González, R Gilberto; Schaefer, Pamela W.; Buonanno, Ferdinando S.; Schwamm, Lee H; Budzik, Ronald F; Rordorf, Guy; Wang, Bing; Sorensen, A. Gregory; Koroshetz, Walter J.

doi:10.1148/radiology.210.1.r99ja02155

Cited by 529 publications

(298 citation statements)

References 20 publications

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“…The difference in sensitivity of DWI and conventional MRI sequences is more in the initial time period and decreases as time progresses. Results of this study are correlated with a study done by Gonzalez et al (2) who concluded that DWI is superior to conventional MRI in the diagnosis and characterization of acute infarct. In this study restricted diffusion was noted in 100% of acute infarcts.…”

Section: Infarctssupporting

confidence: 82%

Detection of Diffusion-Weighted and Apparent Diffusion Coefficient MRI Abnormalities in 100 Patients with Stroke

A.¹

2017

jmscr

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Section: Infarctssupporting

confidence: 82%

Detection of Diffusion-Weighted and Apparent Diffusion Coefficient MRI Abnormalities in 100 Patients with Stroke

A.¹

2017

jmscr

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“…As explained above, DWI-MR has been shown to accurately delineate the cerebral infarct. 5,8,52 In order to avoid pitfalls related to biphasic phenomena, 39,40 we chose to use the DWI-MR results obtained at a median of 3 days (interquartile range, 3-4 days) after stroke as a reference.…”

Section: Correlation Between Admission Perfusion Computed Tomography mentioning

confidence: 99%

Prognostic accuracy of cerebral blood flow measurement by perfusion computed tomography, at the time of emergency room admission, in acute stroke patients

Wintermark¹,

Reichhart²,

Thiran

et al. 2002

Annals of Neurology

460

283

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The purpose of this study was to determine the prognostic accuracy of perfusion computed tomography (CT), performed at the time of emergency room admission, in acute stroke patients. Accuracy was determined by comparison of perfusion CT with delayed magnetic resonance (MR) and by monitoring the evolution of each patient's clinical condition. Twentytwo acute stroke patients underwent perfusion CT covering four contiguous 10mm slices on admission, as well as delayed MR, performed after a median interval of 3 days after emergency room admission. Eight were treated with thrombolytic agents. Infarct size on the admission perfusion CT was compared with that on the delayed diffusion-weighted (DWI)-MR, chosen as the gold standard. Delayed magnetic resonance angiography and perfusion-weighted MR were used to detect recanalization. A potential recuperation ratio, defined as PRR ‫؍‬ penumbra size/(penumbra size ؉ infarct size) on the admission perfusion CT, was compared with the evolution in each patient's clinical condition, defined by the National Institutes of Health Stroke Scale (NIHSS). In the 8 cases with arterial recanalization, the size of the cerebral infarct on the delayed DWI-MR was larger than or equal to that of the infarct on the admission perfusion CT, but smaller than or equal to that of the ischemic lesion on the admission perfusion CT; and the observed improvement in the NIHSS correlated with the PRR (correlation coefficient ‫؍‬ 0.833). In the 14 cases with persistent arterial occlusion, infarct size on the delayed DWI-MR correlated with ischemic lesion size on the admission perfusion CT (r ‫؍‬ 0.958). In all 22 patients, the admission NIHSS correlated with the size of the ischemic area on the admission perfusion CT (r ‫؍‬ 0.627). Based on these findings, we conclude that perfusion CT allows the accurate prediction of the final infarct size and the evaluation of clinical prognosis for acute stroke patients at the time of emergency evaluation. It may also provide information about the extent of the penumbra. Perfusion CT could therefore be a valuable tool in the early management of acute stroke patients.

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“…8,19,21) In humans with partial status epilepticus, vasogenic edema is considered to be the most probable mechanism for reversible changes seen on MR imaging. 6,19) Cytotoxic edema after prolonged seizure is caused by water shifting from the extracellular space to the intracellular compartment, so that diffusion of water is restricted by cell membranes in the acutely damaged cells. Further evidence of blood-brain barrier breakdown and vasogenic edema has been shown in humans with prolonged partial status epilepticus, as angiography showed capillary blush in the focal area and computed tomography demonstrated focal cerebral edema.…”

Section: Discussionmentioning

confidence: 99%

Transient Occipitotemporal Subcortical Diffusion-Weighted Magnetic Resonance Imaging Abnormalities Associated With Status Epilepticus-Case Report-

Tucker

Miyake

Tsuji

et al. 2006

Neurol. Med. Chir.(Tokyo)

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A 30-year-old man presented with a generalized seizure manifesting as decreased consciousness. Diffusion-weighted magnetic resonance imaging showed transient areas of high intensity in the gray and subcortical white matter of the left occipital and temporal lobes. The lesions did not reflect the vascular territories. After a period of over 2 weeks, his consciousness level improved associated with reduced intensity of the abnormal areas. These findings suggest that seizure induced reversible cytotoxic and vasogenic edema. Transient diffusion-weighted magnetic resonance imaging abnormalities may be associated with generalized seizures and the intensity may reflect the clinical condition.

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Diffusion-weighted MR Imaging: Diagnostic Accuracy in Patients Imaged within 6 Hours of Stroke Symptom Onset

Abstract: Diffusion-weighted MR imaging is highly accurate for diagnosing stroke within 6 hours of symptom onset and is superior to CT and conventional MR imaging.

Cited by 529 publications

References 20 publications

Detection of Diffusion-Weighted and Apparent Diffusion Coefficient MRI Abnormalities in 100 Patients with Stroke

Detection of Diffusion-Weighted and Apparent Diffusion Coefficient MRI Abnormalities in 100 Patients with Stroke

Prognostic accuracy of cerebral blood flow measurement by perfusion computed tomography, at the time of emergency room admission, in acute stroke patients

Transient Occipitotemporal Subcortical Diffusion-Weighted Magnetic Resonance Imaging Abnormalities Associated With Status Epilepticus-Case Report-

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