Magnetic resonance prediction of outcome after thrombolytic treatment

Pillekamp, Frank; Grüne, Matthias; Brinker, Gerrit; Franke, Claudia; Uhlenküken, Ulla; Hoehn, Mathias; Hossmann, Konstantin‐Alexander

doi:10.1016/s0730-725x(01)00293-4

Cited by 30 publications

(21 citation statements)

References 41 publications

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“…Parameter images were segmented and analyzed using a set of macros written for the NIH Image software (NIH, Bethesda, MD) (25). The analysis was restricted to the coronal slice at the level of the caudate-putamen, for which all four parameter images (ADC, CBF i , T 2 , and T 1 ) were available.…”

Section: Discussionmentioning

confidence: 99%

“…These authors concluded that the combination of ADC and T 2 might enhance the prediction of infarction, although the time point at which these parameter images are measured may be critical. In our previous study on thrombolytic recanalization of MCA clot embolism, a limited prognostic significance of MR changes was found which was attributed to the unpredictability of postischemic recirculation, as inherent to the thrombolytic model (25).…”

Section: Prediction Of Postischemic Recoverymentioning

confidence: 97%

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Dynamic changes of ADC, perfusion, and NMR relaxation parameters in transient focal ischemia of rat brain

Dorsten

Oláh

Schwindt

et al. 2001

Magnetic Resonance in Med

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The potential of multiparametric MRI parameters for differentiating between reversibly and irreversibly damaged brain tissue was investigated in an experimental model of focal brain ischemia in the rat. The middle cerebral artery (MCA) was occluded by intraluminal suture insertion for 60 or 90 min, followed by 4.5 h of reperfusion. The apparent diffusion coefficient (ADC) of brain water, T 1 and T 2 relaxation times, and CBF i , an MRderived index of cerebral perfusion, were repeatedly measured and correlated with the outcome from the ischemic impact. A novel user-independent approach for segmentation of ADC maps into classes of increasing injury was introduced to define regions of interest (ROIs) in which these parameters were evaluated. MCA occlusion led to a graded decline of ADC, which corresponded with both the severity of flow reduction and an increase in T 1 and T 2 relaxation times. Removal of the suture led to a triphasic restitution of blood flow consisting of a fast initial rise, a secondary decline, and final normalization. Postischemic reperfusion led to a rise of ADC irrespective of the duration of ischemia. However, the quality of recovery declined with increasing severity of the ischemic impact. Throughout the observation time, T 1 and T 2 showed a continuous increase, the intensity of which correlated with the severity of ADC decline during ischemia. Particularly with longer ischemia time, elevated T 2 in combination with reduced ADC yielded a lower probability of recovery during recirculation, while intraischemic perfusion information contributed less to the prediction of outcome. In conclusion, the combination of MR parameters at the end of ischemia correlated with the probability of tissue recovery but did not permit reliable differentiation between reversibly and irreversibly damaged tissue. Magn Reson Med 47:97-104, 2002.

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Section: Discussionmentioning

confidence: 99%

Section: Prediction Of Postischemic Recoverymentioning

confidence: 97%

Dynamic changes of ADC, perfusion, and NMR relaxation parameters in transient focal ischemia of rat brain

Dorsten

Oláh

Schwindt

et al. 2001

Magnetic Resonance in Med

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“…Thus, severe initial ADC decreases do not uniformly predict infarction. 7,24 Two regions of ADC normalization were observed: white matter (Figure 2a) and parts of the basal ganglia (Figure 2b). It was somewhat surprising to detect a partial ADC normalization in the basal ganglia because the opposite has been shown in experimental work.…”

Section: Fiehler Et Al Signatures Of Infarction and Recovery In Strokmentioning

confidence: 99%

Predictors of Apparent Diffusion Coefficient Normalization in Stroke Patients

Fiehler

Knudsen

Kucinski

et al. 2004

Stroke

192

127

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Background and Purpose-We sought to describe the frequency of normalization of apparent diffusion coefficient (ADC) values that are decreased in hyperacute stroke and to identify characteristics of tissue demonstrating normalization. Methods-Sixty-eight acute ischemic stroke patients underwent MRI examination (including diffusion/perfusion imaging and MR angiography) within 6 hours (mean, 2.8 hours) after symptom onset, after 24 hours, and again 4 to 7 days later. Lesion volumes with decreased ADC and delayed time to peak in perfusion imaging were determined. In patients showing ADC normalization, volumes with ADC decrease graded as Ͻ50%, 50% to 60%, 60% to 70%, and 70% to 80% of the contralateral value were determined by thresholding. Patients were categorized as normalizers (demonstrating ADC normalization in Ͼ5 mL tissue with initially decreased ADC) or nonnormalizers (demonstrating ADC normalization in Ͻ5 mL tissue). Results-Fourteen patients (19.7%) were classified as normalizers. Eleven of 31 patients (35.5%) initially imaged Ͻ3 hours after stroke onset and 3 of 37 (7.5%) of those imaged 3 to 6 hours after onset were normalizers. ADC normalization occurred predominantly in the basal ganglia and white matter after thrombolytic therapy in patients with more distal vessel occlusions. All normalizers demonstrated at least partial tissue reperfusion. Tissue with more severe initial decrease in ADC was less likely to demonstrate normalization. Conclusions-ADC normalization is not a rare event in acute stroke after tissue reperfusion. Brain tissue with initially decreased ADC, especially within 3 hours after stroke onset, may include "tissue at risk." (Stroke. 2004;35:514-519.)

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“…3,4 Previous MRI studies in rats have suggested parameters like the mismatch of diffusion-weighted and perfusion-weighted imaging or apparent diffusion coefficient as predictors for final tissue outcome if acquired during the acute phase of stroke. [5][6][7][8][9][10] However, a generally accepted method for the prediction of tissue fate from MRI data is still lacking. 11 The purpose of this PET study in a rat embolic stroke model was (1) …”

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Potential of Early [ ¹⁸ F]-2-Fluoro-2-Deoxy-D-Glucose Positron Emission Tomography for Identifying Hypoperfusion and Predicting Fate of Tissue in a Rat Embolic Stroke Model

Walberer

Backes

Rueger

et al. 2012

Stroke

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Magnetic resonance prediction of outcome after thrombolytic treatment

Cited by 30 publications

References 41 publications

Dynamic changes of ADC, perfusion, and NMR relaxation parameters in transient focal ischemia of rat brain

Dynamic changes of ADC, perfusion, and NMR relaxation parameters in transient focal ischemia of rat brain

Predictors of Apparent Diffusion Coefficient Normalization in Stroke Patients

Potential of Early [ ¹⁸ F]-2-Fluoro-2-Deoxy-D-Glucose Positron Emission Tomography for Identifying Hypoperfusion and Predicting Fate of Tissue in a Rat Embolic Stroke Model

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Magnetic resonance prediction of outcome after thrombolytic treatment

Cited by 30 publications

References 41 publications

Dynamic changes of ADC, perfusion, and NMR relaxation parameters in transient focal ischemia of rat brain

Dynamic changes of ADC, perfusion, and NMR relaxation parameters in transient focal ischemia of rat brain

Predictors of Apparent Diffusion Coefficient Normalization in Stroke Patients

Potential of Early [ 18 F]-2-Fluoro-2-Deoxy-D-Glucose Positron Emission Tomography for Identifying Hypoperfusion and Predicting Fate of Tissue in a Rat Embolic Stroke Model

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Potential of Early [ ¹⁸ F]-2-Fluoro-2-Deoxy-D-Glucose Positron Emission Tomography for Identifying Hypoperfusion and Predicting Fate of Tissue in a Rat Embolic Stroke Model