Imaging of Brain Infarctions: Beyond the Usual Territories

Abdelrasoul, Ahmed Abdelzaher; Elsebaie, Nermeen; Gamaleldin, Omneya; Khalifa, Mohamed Hossameldin; Razek, Ahmed Abdel Khalek Abdel

doi:10.1097/rct.0000000000000865

Cited by 52 publications

(7 citation statements)

References 32 publications

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“…Given that CT is widely available and has a shorter acquisition time, it is now recommended to use CT over MRI due to the importance of initiating treatment early 2 . Nevertheless, MRI offers valuable information in challenging cases and better delineation of ischemic lesions in the early stages of the disease due to its unsurpassed contrast resolution 3 , 4 . Furthermore, the volume of the ischemic core assessed using diffusion-weighted imaging (DWI) provides essential insights for decision-making.…”

Section: Introductionmentioning

confidence: 99%

Inter-vendor performance of deep learning in segmenting acute ischemic lesions on diffusion-weighted imaging: a multicenter study

Aliş

Yergin

Alış

et al. 2021

Sci Rep

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There is little evidence on the applicability of deep learning (DL) in the segmentation of acute ischemic lesions on diffusion-weighted imaging (DWI) between magnetic resonance imaging (MRI) scanners of different manufacturers. We retrospectively included DWI data of patients with acute ischemic lesions from six centers. Dataset A (n = 2986) and B (n = 3951) included data from Siemens and GE MRI scanners, respectively. The datasets were split into the training (80%), validation (10%), and internal test (10%) sets, and six neuroradiologists created ground-truth masks. Models A and B were the proposed neural networks trained on datasets A and B. The models subsequently fine-tuned across the datasets using their validation data. Another radiologist performed the segmentation on the test sets for comparisons. The median Dice scores of models A and B were 0.858 and 0.857 for the internal tests, which were non-inferior to the radiologist’s performance, but demonstrated lower performance than the radiologist on the external tests. Fine-tuned models A and B achieved median Dice scores of 0.832 and 0.846, which were non-inferior to the radiologist's performance on the external tests. The present work shows that the inter-vendor operability of deep learning for the segmentation of ischemic lesions on DWI might be enhanced via transfer learning; thereby, their clinical applicability and generalizability could be improved.

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Section: Introductionmentioning

confidence: 99%

Inter-vendor performance of deep learning in segmenting acute ischemic lesions on diffusion-weighted imaging: a multicenter study

Aliş

Yergin

Alış

et al. 2021

Sci Rep

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“…Por otro lado, son descritos cuatro patrones de imagen distintos del infarto de la arteria de Percheron, talámico paramediano bilateral con afectación del mesencéfalo rostral; talámico paramediano bilateral sin afectación del mesencéfalo; paramediano bilateral y talámico anterior con afectación del mesencéfalo; y paramediano bilateral y talámico anterior sin afectación del mesencéfalo 18 .…”

Section: Discussionunclassified

¿Existe correlación metabólica hipoglucémica y el síndrome de Percheron? Reporte de caso

Avellaneda¹,

Camacho²,

Pérez-Hostia

et al. 2022

revsal

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Introducción: el síndrome de Percheron es causa de lesiones isquémicas talamicas bilaterales ocasionando una serie de anomalías clínicas como: alteración del estado de conciencia, oftalmoplejias, y alteraciones de la memoria. Caso clínico: presentamos el caso de una mujer de 49 años con diabetes mellitus, mal control metabólico, episodios hipoglucémicos e hiperglucemicos repetitivos, quien cursa con sintomatología inespecífica, se realizan estudios imagenológicos no invasivos documentado lesiones talamica bilaterales. Conclusiones: los cuadros subagudos e isquémicos parciales que involucran la región paramediana del Talamo bilateral podrían tener alguna relación con episodios hipoglucémicos e hiperglucemicos repetitivos, que pueden llegar a cursar con sintomatología leve e inespecífica, lo cual lo convierte un reto diagnóstico para este síndrome.

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“…However, it should be noted that a significant portion of type I and II COS/COPS presentations (> 18%) may be classified as "unknown", which includes etiologies such as isolated MCA stenosis, post intracranial bypass surgery complications, or rare drug side-effects, but still the largest proportion of cases included in the "unknown" category presented without identifiable etiology or an identifiable lesion upon imaging (approximately 10%) [5]. Irrespective of the specific subtype of COS/COPS, the most common location of lesions is found at the thalamus, followed by the pons, cortex, internal capsule, cervical cord, corona radiata, medulla oblongata, midbrain, or at multiple sites [2,5,8].…”

Section: Case Reportmentioning

confidence: 99%

Cheiro-oral-pedal syndrome of the pons and the role of imaging in diagnosis and management

Merhavy,

Barfoot,

Dajani

et al. 2023

Exploration of Medicine

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The patient is a 58-year-old male who presented with chief complaints of right-sided numbness, tingling, and loss of temperature sensation in the upper and lower extremities. The patient’s symptoms began around the face and right corner of the mouth [maxillary/mandibular (V2/V3) distribution] before descending to the arm, trunk, and followed by the lower leg and foot. His home medication regimen included lisinopril, atorvastatin, long and short-acting insulin, and amlodipine. During the interview, the patient admitted to abstinence from his medications. Upon examination, the patient was found to have a loss of hot and cold touch on the right side and expressed 2+ reflexes (brisk response; normal) on both upper and lower extremities. In the initial work-up of the patient, he received a computed tomography (CT) scan which demonstrated an area of potential ischemic infarct of one of the left sided pontine perforator arteries. Immediately at that time he was given a loading dose of 325 mg aspirin and started on 81 mg daily. Because of the patient’s symptoms and risk factors, he was hospitalized for further additional work-up and eventually discharged on dual antiplatelet therapy. This case is intriguing as both neuroradiological reading and neurological examination helped with localization of the lesion and changing the treatment strategy of the patient. With a pontine perforator ischemic event, the harms of treatment with thrombolytics would have outweighed the benefits. This interprofessional work between neuroradiology, internal medicine, and neurology ensured that the patient received the best care for his specific ailments.

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Imaging of Brain Infarctions: Beyond the Usual Territories

Cited by 52 publications

References 32 publications

Inter-vendor performance of deep learning in segmenting acute ischemic lesions on diffusion-weighted imaging: a multicenter study

Inter-vendor performance of deep learning in segmenting acute ischemic lesions on diffusion-weighted imaging: a multicenter study

¿Existe correlación metabólica hipoglucémica y el síndrome de Percheron? Reporte de caso

Cheiro-oral-pedal syndrome of the pons and the role of imaging in diagnosis and management

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