The diagnostic value of susceptibility-weighted imaging for ischemic penumbra in patients with acute ischemic stroke

Wang, Tianle; Zhu, Li; Hu, Chunhong; Gong, Shenchu; Jiang, Hongbiao; Chen, Haitao; Li, Jia

doi:10.3233/thc-171348

Cited by 7 publications

(5 citation statements)

References 27 publications

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“…These results are consistent with Abu-samra, M. [18], Wang et al [22] and Wu et al [23], who stated that there was no signi cant difference between the SWI and CTP ASPECT scores, but there was a signi cant difference between the SWI and DWI ASPECT scores. Their ndings suggest that penumbra could be detected by SWI-DWI and that mismatch might indicate the extent of the ischemic penumbra and guide patients who need thrombolytic therapy quickly [19] Our study had many limitations, the most signi cant of which were the small sample size and the absences of gold standard as our diagnosis was made only by imaging and clinical, which may have in uenced our results.…”

Section: Discussionsupporting

confidence: 90%

Additive Role of Susceptibility weighted image To Diffusion weighted image in the diagnosis Of Patients with Acute Stroke

Rahma

Khadrah

Elsafa

et al. 2022

Preprint

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Background Acute ischemic stroke is defined as decrease in the brain blood supply caused by a blood vessel burst or being blocked by a thrombus, resulting in decreased oxygen and nutrients supply, causing brain tissue damage. Diffusion weighted sequences (DWI) gave us data on the pathophysiology of ischemia and may contribute to therapeutic decisions. Susceptibility weighted (SWI) sequences also have the potential to assess tissue viability. An ischemic area showed increased oxygen extraction fraction and slow flow contributed to greater level of deoxyhemoglobin and vein dilatation, which increases the prominence of vessels on SWI. This prominent vessel sign (PVS) on SWI has been reported due to increased oxygen extraction and matches well with venous and capillary deoxyhemoglobin levels. We aimed in this study to highlight the role of the addition of susceptibility weighted MR images to diffusion weighted images of the brain in the diagnosis of patients with acute stroke. Results: Prominent vessel sign (PVS) on SWI was found in 46 (76.7%) patients. Twelve (20%) patients had haemorrhage (low signals) on SWI and 2 (3.3%) patients had no SWI findings. DWI showed a sensitivity of (100%) and SWI showed a sensitivity of (96.7%) for the detection of infarct All of the 60 (100%) patients showed hyperintense signals on T2WIs, FLAIR sequences, and on DWI and hypointense signals on the ADC map. Conclusions: SWI is a potential adjunct in individuals with acute infarction, SWI may be helpful in identifying asymmetrical conspicuous hypointense arteries, positive DWI-SWI mismatch is an indicator of the ischemic penumbra and a prognostic indicator for infarct expansion.

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Section: Discussionsupporting

confidence: 90%

Additive Role of Susceptibility weighted image To Diffusion weighted image in the diagnosis Of Patients with Acute Stroke

Rahma

Khadrah

Elsafa

et al. 2022

Preprint

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“…SWI can provide a metabolic examination capability similar to The Mean Transit Time (MTT) ( Jiang et al, 2021 ) and correlate with other perfusion indicators ( Luo et al, 2017 ). Further research suggests that SWI-DWI mismatch and DWI-PWI (MTT) mismatch have similar effects ( Dejobert et al, 2016 ; Wang et al, 2017 ).…”

Section: Discussionmentioning

confidence: 99%

SWI and CTP fusion model based on sparse representation method to predict cerebral infarction trend

Wu,

Wang,

et al. 2024

Front. Neurosci.

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ObjectiveSWI image signal is related to venous reflux disorder and perfusion defect. Computed tomography perfusion (CTP) contains perfusion information in space and time. There is a complementary basis between them to affect the prognosis of cerebral infarction.MethodsSixty-six patients included in the retrospective study were designated as the training set. Effective perfusion indicator features and imaging radiomic features of the peri-infarction area on Susceptibility weighted imaging (SWI) and CTP modality images were extracted from each case. Thirty-three patients from the prospectively included group were designated as the test set of the machine learning model based on a sparse representation method. The predicted results were compared with the DWI results of the patients’ 7–10 days review to assess the validity and accuracy of the prediction.ResultsThe AUC of the SWI + CTP integrated model was 0.952, the ACC was 0.909, the SEN was 0.889, and the SPE was 0.933. The prediction performance is the highest. Compared with the value of AUC: the SWI model is 0.874, inferior to the performance of the SWI + CTP model, and the CTP model is 0.715.ConclusionThe prediction efficiency of the changing trend of infarction volume is further improved by the correlation between the combination of the two image features.

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“…Since Morita et al [ 6 ] firstly described this distinctive vessel sign in acute stroke patients, defined as the hypo-intensity and dilation of veins in the deep white matter on SWI compared to the unaffected hemisphere, the appearance of prominent or asymmetric medullary veins on the affected side was correlated with stroke severity [ 12 , 13 , 16 , 20 , 39 , 40 ], infarction volume [ 9 , 12 , 13 ], and poor outcome [ 9 , 10 , 13 ] in some of the previous investigations. The underlying mechanism is mainly focused on slow drainage and enlargement of veins due to increased oxygen extraction fractions (OEF) in the hypoperfusion tissue and/or cytotoxic edema within the infarct area, leading to an increased level of deoxyhemoglobin [ 6 , 7 , 8 , 22 ].…”

Section: Discussionmentioning

confidence: 99%

Association between Deep Medullary Veins in the Unaffected Hemisphere and Functional Outcome in Acute Cardioembolic Stroke: An Observational Retrospective Study

Liu

Wei

et al. 2022

Brain Sciences

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Objective: To explore whether deep medullary veins (DMVs) in the unaffected hemisphere were associated with functional outcome in acute cardioembolic stroke patients. Methods: Acute cardioembolic stroke patients at a single center were retrospectively included. DMVs visibility in the unaffected hemisphere was assessed using a well-established four-grade scoring method based on susceptibility-weighted imaging (SWI): grades 0–3 (grade 0 for no visible DMVs; grade 1 for the numbers of conspicuous DMVs < 5; grade 2 for numbers raging from 5 to 10; grade 3 for more than 10). Patients were further divided into mild-to-moderate (grade 0–2) and severe DMVs (grade 3) groups. Functional outcomes were evaluated using the modified Rankin scale (mRS) score at three months. Poor outcome was defined as mRS ≥ 3. Binary logistic regression analysis was used to explore the association between DMVs grade and functional outcome. Results: A total of 170 patients were finally included. Compared with the mild-to-moderate DMVs group (149 patients), the severe DMVs group (21 patients) had higher baseline National Institutes of Health Stroke Scale (NIHSS) scores (p = 0.002), lower levels of admission systolic blood pressure (BP) (p = 0.031), and elevated rates of large infarction (p = 0.003). At three months, the severe DMVs group had higher mRS (p = 0.002). Patients in the poor outcome group (82/170, 48.2%) had older age, higher baseline NIHSS score, lower admission diastolic BP, higher rates of hemorrhagic transformation and large infarction, and an increased proportion of severe DMVs (all p < 0.05). After adjusting for confounders, multivariable regression analysis showed that the severe DMVs grade (adjusted odds ratio [OR] = 5.830, 95% confidence interval [CI] = 1.266–26.856, p = 0.024) was significantly associated with three-month functional outcomes without interaction with other potential risk factors (p for interaction > 0.05). Conclusions: DMVs grade in the unaffected hemisphere was independently associated with three-month functional outcome in acute cardioembolic stroke patients. Patients with severe DMVs were more likely to have a poor functional outcome at three months.

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The diagnostic value of susceptibility-weighted imaging for ischemic penumbra in patients with acute ischemic stroke

Cited by 7 publications

References 27 publications

Additive Role of Susceptibility weighted image To Diffusion weighted image in the diagnosis Of Patients with Acute Stroke

Additive Role of Susceptibility weighted image To Diffusion weighted image in the diagnosis Of Patients with Acute Stroke

SWI and CTP fusion model based on sparse representation method to predict cerebral infarction trend

Association between Deep Medullary Veins in the Unaffected Hemisphere and Functional Outcome in Acute Cardioembolic Stroke: An Observational Retrospective Study

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