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<meta name="DC.Title" content="Predicting Cerebral Ischemic Infarct Volume with Diffusion and Perfusion MR Imaging" />
<meta name="DC.Date" content="2002-11-01" />
<meta name="DC.Publisher" content="American Journal of Neuroradiology" />
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<meta name="DC.Description" content="BACKGROUND AND PURPOSE: Diffusion and perfusion MR imaging have proved useful in the assessment of acute stroke. We evaluated the utility of these techniques in detecting acute ischemic infarction and in predicting final infarct size.

METHODS: Diffusion and hemodynamic images were obtained in 134 patients within a mean of 12.3 hours of onset of acute ischemic stroke symptoms. We retrospectively reviewed patient radiology reports to determine the presence or absence of lesion identification on initial diffusion- (DW) and perfusion-weighted (PW) images. Radiologists were not blinded to the initial clinical assessment. For determination of sensitivity and specificity, the final discharge diagnosis was used as the criterion standard. Neurologists were not blinded to the DW or PW imaging findings. In 81 patients, acute lesions were compared with final infarct volumes.

RESULTS: Sensitivities of DW imaging and cerebral blood volume (CBV), cerebral blood flow (CBF), and mean transit time (MTT) perfusion parameters were 94%, 74%, 84%, and 84%, respectively. Specificities of DW imaging, CBV, CBF, and MTT were 96%, 100%, 96%, and 96%, respectively. Results were similar in 93 patients imaged within 12 hours. In 81 patients with follow-up, regression analysis yielded r 2 = 0.9, slope = 1.24 for DW imaging; r 2 = 0.84, slope = 1 .22 for CBV; r 2 = 0.35, slope = 0.44 for CBF; and r 2 = 0.22, slope = 0.32 for MTT, versus follow-up volume. A DW-CBV mismatch predicted additional lesion growth, whereas DW-CBF and DW-MTT mismatches did not. Results were similar in 60 patients imaged within 12 hours.

CONCLUSION: Diffusion and hemodynamic images are sensitive and specific for detecting acute infarction. DW imaging and CBV best predict final infarct volume. DW-CBV mismatch predicts lesion growth into the CBV abnormality. CBF and MTT help identify additional tissue with altered perfusion but have lower correlation with final volume." />
<meta name="DC.Contributor" content="Pamela W. Schaefer" />
<meta name="DC.Contributor" content="George J. Hunter" />
<meta name="DC.Contributor" content="Julian He" />
<meta name="DC.Contributor" content="Leena M. Hamberg" />
<meta name="DC.Contributor" content="A. Gregory Sorensen" />
<meta name="DC.Contributor" content="Lee H. Schwamm" />
<meta name="DC.Contributor" content="Walter J. Koroshetz" />
<meta name="DC.Contributor" content="R. Gilberto Gonzalez" />
<meta name="article:published_time" content="2002-11-01" />
<meta name="article:section" content="BRAIN" />
<meta name="citation_title" content="Predicting Cerebral Ischemic Infarct Volume with Diffusion and Perfusion MR Imaging" />
<meta name="citation_abstract" lang="en" content="&lt;p&gt;&lt;i&gt;BACKGROUND AND PURPOSE:&lt;/i&gt; Diffusion and perfusion MR imaging have proved useful in the assessment of acute stroke. We evaluated the utility of these techniques in detecting acute ischemic infarction and in predicting final infarct size.&lt;/p&gt;&lt;p&gt;&lt;i&gt;METHODS:&lt;/i&gt; Diffusion and hemodynamic images were obtained in 134 patients within a mean of 12.3 hours of onset of acute ischemic stroke symptoms. We retrospectively reviewed patient radiology reports to determine the presence or absence of lesion identification on initial diffusion- (DW) and perfusion-weighted (PW) images. Radiologists were not blinded to the initial clinical assessment. For determination of sensitivity and specificity, the final discharge diagnosis was used as the criterion standard. Neurologists were not blinded to the DW or PW imaging findings. In 81 patients, acute lesions were compared with final infarct volumes.&lt;/p&gt;&lt;p&gt;&lt;i&gt;RESULTS:&lt;/i&gt; Sensitivities of DW imaging and cerebral blood volume (CBV), cerebral blood flow (CBF), and mean transit time (MTT) perfusion parameters were 94%, 74%, 84%, and 84%, respectively. Specificities of DW imaging, CBV, CBF, and MTT were 96%, 100%, 96%, and 96%, respectively. Results were similar in 93 patients imaged within 12 hours. In 81 patients with follow-up, regression analysis yielded &lt;i&gt;r&lt;/i&gt;&lt;sup&gt;2&lt;/sup&gt; = 0.9, slope = 1.24 for DW imaging; &lt;i&gt;r&lt;/i&gt;&lt;sup&gt;2&lt;/sup&gt; = 0.84, slope = 1 .22 for CBV; &lt;i&gt;r&lt;/i&gt;&lt;sup&gt;2&lt;/sup&gt; = 0.35, slope = 0.44 for CBF; and &lt;i&gt;r&lt;/i&gt;&lt;sup&gt;2&lt;/sup&gt; = 0.22, slope = 0.32 for MTT, versus follow-up volume. A DW-CBV mismatch predicted additional lesion growth, whereas DW-CBF and DW-MTT mismatches did not. Results were similar in 60 patients imaged within 12 hours.&lt;/p&gt;&lt;p&gt;&lt;i&gt;CONCLUSION:&lt;/i&gt; Diffusion and hemodynamic images are sensitive and specific for detecting acute infarction. DW imaging and CBV best predict final infarct volume. DW-CBV mismatch predicts lesion growth into the CBV abnormality. CBF and MTT help identify additional tissue with altered perfusion but have lower correlation with final volume.&lt;/p&gt;" />
<meta name="citation_journal_title" content="American Journal of Neuroradiology" />
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<meta name="twitter:title" content="Predicting Cerebral Ischemic Infarct Volume with Diffusion and Perfusion MR Imaging" />
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<meta name="twitter:description" content="BACKGROUND AND PURPOSE: Diffusion and perfusion MR imaging have proved useful in the assessment of acute stroke. We evaluated the utility of these techniques in detecting acute ischemic infarction and in predicting final infarct size.

METHODS: Diffusion and hemodynamic images were obtained in 134 patients within a mean of 12.3 hours of onset of acute ischemic stroke symptoms. We retrospectively reviewed patient radiology reports to determine the presence or absence of lesion identification on initial diffusion- (DW) and perfusion-weighted (PW) images. Radiologists were not blinded to the initial clinical assessment. For determination of sensitivity and specificity, the final discharge diagnosis was used as the criterion standard. Neurologists were not blinded to the DW or PW imaging findings. In 81 patients, acute lesions were compared with final infarct volumes.

RESULTS: Sensitivities of DW imaging and cerebral blood volume (CBV), cerebral blood flow (CBF), and mean transit time (MTT) perfusion parameters were 94%, 74%, 84%, and 84%, respectively. Specificities of DW imaging, CBV, CBF, and MTT were 96%, 100%, 96%, and 96%, respectively. Results were similar in 93 patients imaged within 12 hours. In 81 patients with follow-up, regression analysis yielded r 2 = 0.9, slope = 1.24 for DW imaging; r 2 = 0.84, slope = 1 .22 for CBV; r 2 = 0.35, slope = 0.44 for CBF; and r 2 = 0.22, slope = 0.32 for MTT, versus follow-up volume. A DW-CBV mismatch predicted additional lesion growth, whereas DW-CBF and DW-MTT mismatches did not. Results were similar in 60 patients imaged within 12 hours.

CONCLUSION: Diffusion and hemodynamic images are sensitive and specific for detecting acute infarction. DW imaging and CBV best predict final infarct volume. DW-CBV mismatch predicts lesion growth into the CBV abnormality. CBF and MTT help identify additional tissue with altered perfusion but have lower correlation with final volume." />
<meta name="og-title" property="og:title" content="Predicting Cerebral Ischemic Infarct Volume with Diffusion and Perfusion MR Imaging" />
<meta name="og-url" property="og:url" content="http://ajnr-stage2.stage.highwire.org/content/23/10/1785" />
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<meta name="og-description" property="og:description" content="BACKGROUND AND PURPOSE: Diffusion and perfusion MR imaging have proved useful in the assessment of acute stroke. We evaluated the utility of these techniques in detecting acute ischemic infarction and in predicting final infarct size.

METHODS: Diffusion and hemodynamic images were obtained in 134 patients within a mean of 12.3 hours of onset of acute ischemic stroke symptoms. We retrospectively reviewed patient radiology reports to determine the presence or absence of lesion identification on initial diffusion- (DW) and perfusion-weighted (PW) images. Radiologists were not blinded to the initial clinical assessment. For determination of sensitivity and specificity, the final discharge diagnosis was used as the criterion standard. Neurologists were not blinded to the DW or PW imaging findings. In 81 patients, acute lesions were compared with final infarct volumes.

RESULTS: Sensitivities of DW imaging and cerebral blood volume (CBV), cerebral blood flow (CBF), and mean transit time (MTT) perfusion parameters were 94%, 74%, 84%, and 84%, respectively. Specificities of DW imaging, CBV, CBF, and MTT were 96%, 100%, 96%, and 96%, respectively. Results were similar in 93 patients imaged within 12 hours. In 81 patients with follow-up, regression analysis yielded r 2 = 0.9, slope = 1.24 for DW imaging; r 2 = 0.84, slope = 1 .22 for CBV; r 2 = 0.35, slope = 0.44 for CBF; and r 2 = 0.22, slope = 0.32 for MTT, versus follow-up volume. A DW-CBV mismatch predicted additional lesion growth, whereas DW-CBF and DW-MTT mismatches did not. Results were similar in 60 patients imaged within 12 hours.

CONCLUSION: Diffusion and hemodynamic images are sensitive and specific for detecting acute infarction. DW imaging and CBV best predict final infarct volume. DW-CBV mismatch predicts lesion growth into the CBV abnormality. CBF and MTT help identify additional tissue with altered perfusion but have lower correlation with final volume." />
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      <h1 class="highwire-cite-title" id="page-title">Predicting Cerebral Ischemic Infarct Volume with Diffusion and Perfusion MR Imaging</h1>  
    	<div class="highwire-cite-authors"><span  class="highwire-citation-authors"><span class="highwire-citation-author first" data-delta="0">Pamela W. Schaefer</span>, <span class="highwire-citation-author" data-delta="1">George J. Hunter</span>, <span class="highwire-citation-author" data-delta="2">Julian He</span>, <span class="highwire-citation-author" data-delta="3">Leena M. Hamberg</span>, <span class="highwire-citation-author" data-delta="4">A. Gregory Sorensen</span>, <span class="highwire-citation-author" data-delta="5">Lee H. Schwamm</span>, <span class="highwire-citation-author" data-delta="6">Walter J. Koroshetz</span> and <span class="highwire-citation-author" data-delta="7">R. Gilberto Gonzalez</span></span></div>
  
    	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-journal highwire-cite-metadata">American Journal of Neuroradiology </span><span  class="highwire-cite-metadata-date highwire-cite-metadata">November 2002,  </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">23 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(10) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">1785-1794; </span></div>
  
  
  
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<div id="hw-article-author-popups-top-node-10314--61847726896" style="display: none;"><div class="author-tooltip-0"><div class="author-tooltip-name">Pamela W. 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