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<meta name="DC.Title" content="Vascular Occlusion Sites Determine Differences in Lesion Growth from Early Apparent Diffusion Coefficient Lesion to Final Infarct" />
<meta name="DC.Date" content="2005-05-01" />
<meta name="DC.Publisher" content="American Journal of Neuroradiology" />
<meta name="DC.Rights" content="Copyright © American Society of Neuroradiology" />
<meta name="DC.AccessRights" content="restricted" />
<meta name="DC.Description" content="BACKGROUND AND PURPOSE: Occlusion of major cerebral arteries is the primary source of tissue damage in ischemic stroke and the target of thrombolytic therapy. We hypothesized that large infarcts in more proximal vascular occlusions correspond with substantially increased ischemic lesions shown on initial apparent diffusion coefficient (ADC) maps.

METHODS: Initial ADC lesions in 120 patients with acute ischemic stroke were analyzed within 6 hours of stroke onset. Patients were categorized on the basis of vascular occlusion, as shown on MR angiography. Lesion volumes were determined by using manual delineation (ADCman) and a threshold method for ADC values (&lt;550 × 10−9 mm2/s−1, ADC&lt;550). Infarct volumes were analyzed by using T2-weighted ( n = 109) or CT ( n = 11) images obtained on days 5–8.

RESULTS: Median lesion volumes for ADC&lt;550, ADCman, and infarcts, respectively, were as follows: proximal internal carotid artery (ICA)/middle cerebral artery (MCA) occlusions, 10, 23, and 32 cm3; carotid-T occlusions, 11, 37, and 138 cm3; MCA trunk occlusions, 11, 27, and 44 cm3); and MCA branch occlusions 8, 27, and 21 cm3. Initial ADC lesion volumes were different only between the carotid T and the MCA branch ( P &lt; .05). On days 5–8, infarct volumes decreased from proximal to distal sites ( P &lt; .05), with the exception of MCA trunk versus proximal ICA/MCA occlusions. Recanalization rate in carotid-T occlusion was significantly lower than those of all other occlusion types.

CONCLUSION: Initial ADC lesions can be small, even in patients with proximal vascular occlusions. These patients develop considerably large infarctions, suggesting a high potential for infarct growth. This growth might be averted with improved early recanalization of proximal vascular occlusions." />
<meta name="DC.Contributor" content="Jens Fiehler" />
<meta name="DC.Contributor" content="Karina Knudsen" />
<meta name="DC.Contributor" content="Götz Thomalla" />
<meta name="DC.Contributor" content="Einar Goebell" />
<meta name="DC.Contributor" content="Michael Rosenkranz" />
<meta name="DC.Contributor" content="Cornelius Weiller" />
<meta name="DC.Contributor" content="Joachim Röther" />
<meta name="DC.Contributor" content="Hermann Zeumer" />
<meta name="DC.Contributor" content="Thomas Kucinski" />
<meta name="article:published_time" content="2005-05-01" />
<meta name="article:section" content="BRAIN" />
<meta name="citation_title" content="Vascular Occlusion Sites Determine Differences in Lesion Growth from Early Apparent Diffusion Coefficient Lesion to Final Infarct" />
<meta name="citation_abstract" lang="en" content="&lt;p&gt;&lt;i&gt;BACKGROUND AND PURPOSE:&lt;/i&gt; Occlusion of major cerebral arteries is the primary source of tissue damage in ischemic stroke and the target of thrombolytic therapy. We hypothesized that large infarcts in more proximal vascular occlusions correspond with substantially increased ischemic lesions shown on initial apparent diffusion coefficient (ADC) maps.&lt;/p&gt;&lt;p&gt;&lt;i&gt;METHODS:&lt;/i&gt; Initial ADC lesions in 120 patients with acute ischemic stroke were analyzed within 6 hours of stroke onset. Patients were categorized on the basis of vascular occlusion, as shown on MR angiography. Lesion volumes were determined by using manual delineation (ADC&lt;sub&gt;man&lt;/sub&gt;) and a threshold method for ADC values (&amp;lt;550 × 10&lt;sup&gt;−9&lt;/sup&gt; mm&lt;sup&gt;2&lt;/sup&gt;/s&lt;sup&gt;−1&lt;/sup&gt;, ADC&lt;sub&gt;&amp;lt;550&lt;/sub&gt;). Infarct volumes were analyzed by using T2-weighted (&lt;i&gt;n&lt;/i&gt; = 109) or CT (&lt;i&gt;n&lt;/i&gt; = 11) images obtained on days 5–8.&lt;/p&gt;&lt;p&gt;&lt;i&gt;RESULTS:&lt;/i&gt; Median lesion volumes for ADC&lt;sub&gt;&amp;lt;550&lt;/sub&gt;, ADC&lt;sub&gt;man&lt;/sub&gt;, and infarcts, respectively, were as follows: proximal internal carotid artery (ICA)/middle cerebral artery (MCA) occlusions, 10, 23, and 32 cm&lt;sup&gt;3&lt;/sup&gt;; carotid-T occlusions, 11, 37, and 138 cm&lt;sup&gt;3&lt;/sup&gt;; MCA trunk occlusions, 11, 27, and 44 cm&lt;sup&gt;3&lt;/sup&gt;); and MCA branch occlusions 8, 27, and 21 cm&lt;sup&gt;3&lt;/sup&gt;. Initial ADC lesion volumes were different only between the carotid T and the MCA branch (&lt;i&gt;P&lt;/i&gt; &amp;lt; .05). On days 5–8, infarct volumes decreased from proximal to distal sites (&lt;i&gt;P&lt;/i&gt; &amp;lt; .05), with the exception of MCA trunk versus proximal ICA/MCA occlusions. Recanalization rate in carotid-T occlusion was significantly lower than those of all other occlusion types.&lt;/p&gt;&lt;p&gt;&lt;i&gt;CONCLUSION:&lt;/i&gt; Initial ADC lesions can be small, even in patients with proximal vascular occlusions. These patients develop considerably large infarctions, suggesting a high potential for infarct growth. This growth might be averted with improved early recanalization of proximal vascular occlusions.&lt;/p&gt;" />
<meta name="citation_journal_title" content="American Journal of Neuroradiology" />
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<meta name="citation_publication_date" content="2005/05/01" />
<meta name="citation_mjid" content="ajnr;26/5/1056" />
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<meta name="citation_firstpage" content="1056" />
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<meta name="citation_author" content="Jens Fiehler" />
<meta name="citation_author" content="Karina Knudsen" />
<meta name="citation_author" content="Götz Thomalla" />
<meta name="citation_author" content="Einar Goebell" />
<meta name="citation_author" content="Michael Rosenkranz" />
<meta name="citation_author" content="Cornelius Weiller" />
<meta name="citation_author" content="Joachim Röther" />
<meta name="citation_author" content="Hermann Zeumer" />
<meta name="citation_author" content="Thomas Kucinski" />
<meta name="twitter:title" content="Vascular Occlusion Sites Determine Differences in Lesion Growth from Early Apparent Diffusion Coefficient Lesion to Final Infarct" />
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<meta name="twitter:description" content="BACKGROUND AND PURPOSE: Occlusion of major cerebral arteries is the primary source of tissue damage in ischemic stroke and the target of thrombolytic therapy. We hypothesized that large infarcts in more proximal vascular occlusions correspond with substantially increased ischemic lesions shown on initial apparent diffusion coefficient (ADC) maps.

METHODS: Initial ADC lesions in 120 patients with acute ischemic stroke were analyzed within 6 hours of stroke onset. Patients were categorized on the basis of vascular occlusion, as shown on MR angiography. Lesion volumes were determined by using manual delineation (ADCman) and a threshold method for ADC values (&lt;550 × 10−9 mm2/s−1, ADC&lt;550). Infarct volumes were analyzed by using T2-weighted ( n = 109) or CT ( n = 11) images obtained on days 5–8.

RESULTS: Median lesion volumes for ADC&lt;550, ADCman, and infarcts, respectively, were as follows: proximal internal carotid artery (ICA)/middle cerebral artery (MCA) occlusions, 10, 23, and 32 cm3; carotid-T occlusions, 11, 37, and 138 cm3; MCA trunk occlusions, 11, 27, and 44 cm3); and MCA branch occlusions 8, 27, and 21 cm3. Initial ADC lesion volumes were different only between the carotid T and the MCA branch ( P &lt; .05). On days 5–8, infarct volumes decreased from proximal to distal sites ( P &lt; .05), with the exception of MCA trunk versus proximal ICA/MCA occlusions. Recanalization rate in carotid-T occlusion was significantly lower than those of all other occlusion types.

CONCLUSION: Initial ADC lesions can be small, even in patients with proximal vascular occlusions. These patients develop considerably large infarctions, suggesting a high potential for infarct growth. This growth might be averted with improved early recanalization of proximal vascular occlusions." />
<meta name="og-title" property="og:title" content="Vascular Occlusion Sites Determine Differences in Lesion Growth from Early Apparent Diffusion Coefficient Lesion to Final Infarct" />
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<meta name="og-site-name" property="og:site_name" content="American Journal of Neuroradiology" />
<meta name="og-description" property="og:description" content="BACKGROUND AND PURPOSE: Occlusion of major cerebral arteries is the primary source of tissue damage in ischemic stroke and the target of thrombolytic therapy. We hypothesized that large infarcts in more proximal vascular occlusions correspond with substantially increased ischemic lesions shown on initial apparent diffusion coefficient (ADC) maps.

METHODS: Initial ADC lesions in 120 patients with acute ischemic stroke were analyzed within 6 hours of stroke onset. Patients were categorized on the basis of vascular occlusion, as shown on MR angiography. Lesion volumes were determined by using manual delineation (ADCman) and a threshold method for ADC values (&lt;550 × 10−9 mm2/s−1, ADC&lt;550). Infarct volumes were analyzed by using T2-weighted ( n = 109) or CT ( n = 11) images obtained on days 5–8.

RESULTS: Median lesion volumes for ADC&lt;550, ADCman, and infarcts, respectively, were as follows: proximal internal carotid artery (ICA)/middle cerebral artery (MCA) occlusions, 10, 23, and 32 cm3; carotid-T occlusions, 11, 37, and 138 cm3; MCA trunk occlusions, 11, 27, and 44 cm3); and MCA branch occlusions 8, 27, and 21 cm3. Initial ADC lesion volumes were different only between the carotid T and the MCA branch ( P &lt; .05). On days 5–8, infarct volumes decreased from proximal to distal sites ( P &lt; .05), with the exception of MCA trunk versus proximal ICA/MCA occlusions. Recanalization rate in carotid-T occlusion was significantly lower than those of all other occlusion types.

CONCLUSION: Initial ADC lesions can be small, even in patients with proximal vascular occlusions. These patients develop considerably large infarctions, suggesting a high potential for infarct growth. This growth might be averted with improved early recanalization of proximal vascular occlusions." />
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      <h1 class="highwire-cite-title" id="page-title">Vascular Occlusion Sites Determine Differences in Lesion Growth from Early Apparent Diffusion Coefficient Lesion to Final Infarct</h1>  
    	<div class="highwire-cite-authors"><span  class="highwire-citation-authors"><span class="highwire-citation-author first" data-delta="0">Jens Fiehler</span>, <span class="highwire-citation-author" data-delta="1">Karina Knudsen</span>, <span class="highwire-citation-author" data-delta="2">Götz Thomalla</span>, <span class="highwire-citation-author" data-delta="3">Einar Goebell</span>, <span class="highwire-citation-author" data-delta="4">Michael Rosenkranz</span>, <span class="highwire-citation-author" data-delta="5">Cornelius Weiller</span>, <span class="highwire-citation-author" data-delta="6">Joachim Röther</span>, <span class="highwire-citation-author" data-delta="7">Hermann Zeumer</span> and <span class="highwire-citation-author" data-delta="8">Thomas Kucinski</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">May 2005,  </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">26 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(5) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">1056-1061; </span></div>
  
  
  
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<div id="hw-article-author-popups-top-node-2876--61070898014" style="display: none;"><div class="author-tooltip-0"><div class="author-tooltip-name">Jens Fiehler </div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=Jens%2BFiehler%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Fiehler%20J&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link last"><a href="/search/author1%3AJens%2BFiehler%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div><div class="author-tooltip-1"><div class="author-tooltip-name">Karina Knudsen </div><ul 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