Reversible diffusion weighted imaging hyperintensities during the acute phase of ischemic stroke in pediatric moyamoya disease: a case report

Tamura, Goichiro; Ihara, Satoshi; Morota, Nobuhito

doi:10.1007/s00381-016-3052-z

Cited by 6 publications

(4 citation statements)

References 15 publications

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“…Furthermore, there was no correlation between early reperfusion and DWI reversal 64 . Reversibility of diffusion restriction has been reported in pediatric patients with AIS, although this phenomenon has not been well characterized 65 . In a cohort of 29 children with ischemic stroke, the established adult ADC threshold of <620 × 10 –6 mm 2 /s strongly correlated with the DWI lesion in early time windows 63 .…”

Section: Imaging Selection Of Children For Endovascular Stroke Therapymentioning

confidence: 87%

“…64 Reversibility of diffusion restriction has been reported in pediatric patients with AIS, although this phenomenon has not been well characterized. 65 In a cohort of 29 children with ischemic stroke, the established adult ADC threshold of <620 Â 10 -6 mm 2 /s strongly correlated with the DWI lesion in early time windows. 63 Another report of 4 children with acute stroke and MR RAPID perfusion imaging also found that ADC volume <620 Â 10 -6 mm 2 /s correlated with final DWI volume on follow-up imaging.…”

Section: Imaging Selection Of Children For Endovascular Stroke Therapymentioning

confidence: 92%

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Reperfusion Therapies for Children With Arterial Ischemic Stroke

Heit

Muthusami

Chandra

et al. 2021

Topics in Magnetic Resonance Imaging

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Modern hyperacute reperfusion therapies including intravenous thrombolysis and mechanical thrombectomy have transformed the management of arterial ischemic stroke (AIS) in adults. Multiple randomized clinical trials have demonstrated that these therapies enable remarkable improvements in clinical outcome for properly selected patients with AIS. Because pediatric patients were excluded from predicate clinical trials, there is a conspicuous lack of data to guide selection of therapies and inform age-adjusted and pathology-oriented treatment modifications for children. Specifically, technical guidance concerning treatment eligibility, drug dosing, and device implementation is lacking. This review aims to outline important features that differentiate pediatric AIS from adult AIS and provide practical strategies that will assist the stroke specialist with therapeutic decision making.

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Section: Imaging Selection Of Children For Endovascular Stroke Therapymentioning

confidence: 87%

Section: Imaging Selection Of Children For Endovascular Stroke Therapymentioning

confidence: 92%

Reperfusion Therapies for Children With Arterial Ischemic Stroke

Heit

Muthusami

Chandra

et al. 2021

Topics in Magnetic Resonance Imaging

View full text Add to dashboard Cite

show abstract

“…Since the 1990s, the diffusion weighted imaging has recognized as the best technique in early detection of strokes (21)(22)(23)(24)(25). Recently, with the technical development of MR imaging in the areas of imaging sequences and gradient coils, the amount of time required to image other areas of the body has decreased profoundly.…”

Section: Applicationsmentioning

confidence: 99%

MO-FG-CAMPUS-IeP3-03: Optimal Parameters to Determine the Apparent Diffusion Coefficient in Diffusion Weighted Imaging Via Simulation

Perera

Son

2016

Med. Phys.

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Purpose: To investigate in silico how calculation of apparent diffusion coefficient (ADC) is affected by image SNR, b‐values, and the true tissue ADC. Methods: Diffusion‐weighted (DW) images were generated assuming a mono‐exponential signal model with two different b‐values and known true ADC values. Rician noise of different levels was added to the DWI images to adjust the image SNR. Using the two DWI images, ADC was calculated using a mono‐exponential model for each set of b‐values, SNR, and true ADC. 40,000 simulations were performed for each parameter setting to determine the mean and the standard‐deviation of the calculated ADC, as well as the percentage accuracy and precision with respect to the true ADC. In our study, we simulated two true ADCs (ADC 0.00102 for prostate tumor and 0.00180 mm2/s for normal prostate tissue). SNR was varied from 2 to 100 and b‐values were varied from 0 to 2000s/mm2. Results: The accuracy (difference between known and calculated ADC) and precision (standard‐deviation of calculated ADC) were increased with SNR. To increase SNR, 10 signal‐averagings (NEX) were used. The optimal NEX combination for tumor and normal tissue was 2, 8, and the optimal b‐value pair were 0, 1200s/mm2 and 0, 700s/mm2. The minimum accuracy and precision errors were obtained when low b‐value is 0. For any choice of low b‐value until 400s/mm2, the errors were minimized when b‐value difference is approximately 1200 and 700s/mm2 for tumor and normal tissues respectively. For true ADC < 0.00144 mm2/s accuracy and precision improves when high b‐value is around 1200s/mm2. Otherwise, for true ADC > 0.00144 mm2/s, it is around 700s/mm2. Conclusion: Using the optimal choices of parameters for the prostate peripheral region both normal and tumor tissues were calculated with 99% accuracy and 94% precision. Suggestions for parameters choices could be made for any tissue ADC.

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“…However, the association between DWI lesions and the infarction core has been challenged in several recent case reports and systemic analysis of DWI reversal. [1][2][3] These reversals are usually observed in patients with small lesions, relatively higher ADC values, or rapid endovascular reperfusion. [3][4][5][6] Herein, we report a case of reversal of a large ischemic lesion on DWI with corresponding low ADC values in acute middle cerebral artery (MCA) infarction after immediate spontaneous recanalization.…”

mentioning

confidence: 99%

Reversal of a Large Ischemic Lesion with Low Apparent Diffusion Coefficient Value by Rapid Spontaneous Recanalization

Choi

et al. 2022

J Neurosonol Neuroimag

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Cytotoxic edema at the site of a lesion following cerebral infarction is shown as a high signal on diffusion-weighted imaging, with a corresponding decreased apparent diffusion coefficient value on magnetic resonance imaging. These imaging findings have been used clinically as imaging markers of the infarction core, implying irreversible ischemic damage. However, reversal of diffusion lesions has been reported in patients with small lesions, relatively higher values of the apparent diffusion coefficient, or rapid endovascular reperfusion. Herein, we report a case of reversal of a large ischemic lesion on diffusion-weighted imaging with corresponding low apparent diffusion coefficient values in an acute middle cerebral artery infarction after immediate spontaneous recanalization. This case suggests that large ischemic lesions revealed by diffusion-weighted imaging may be reversed upon timely reperfusion, and could be considered as therapeutic targets.

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Reversible diffusion weighted imaging hyperintensities during the acute phase of ischemic stroke in pediatric moyamoya disease: a case report

Cited by 6 publications

References 15 publications

Reperfusion Therapies for Children With Arterial Ischemic Stroke

Reperfusion Therapies for Children With Arterial Ischemic Stroke

MO-FG-CAMPUS-IeP3-03: Optimal Parameters to Determine the Apparent Diffusion Coefficient in Diffusion Weighted Imaging Via Simulation

Reversal of a Large Ischemic Lesion with Low Apparent Diffusion Coefficient Value by Rapid Spontaneous Recanalization

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