Prediction of subacute infarct size in acute middle cerebral artery stroke: comparison of perfusion-weighted imaging and apparent diffusion coefficient maps.
Radiology. 2012-11-01; 265(2): 511-517
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1. Radiology. 2012 Nov;265(2):511-7. doi: 10.1148/radiol.12112430. Epub 2012 Aug 24.
Prediction of subacute infarct size in acute middle cerebral artery stroke:
comparison of perfusion-weighted imaging and apparent diffusion coefficient maps.
Drier A(1), Tourdias T, Attal Y, Sibon I, Mutlu G, Lehéricy S, Samson Y, Chiras
J, Dormont D, Orgogozo JM, Dousset V, Rosso C.
(1)AP-HP Service de Neuroradiologie and AP-HP Urgences Cérébro-Vasculaires,
Hôpital Pitié-Salpêtrière, Paris, France.
PURPOSE: To compare perfusion-weighted (PW) imaging and apparent diffusion
coefficient (ADC) maps in prediction of infarct size and growth in patients with
acute middle cerebral artery infarct.
MATERIALS AND METHODS: This study was approved by the local institutional review
board. Written informed consent was obtained from all 80 patients. Subsequent
infarct volume and growth on follow-up magnetic resonance (MR) images obtained
within 6 days were compared with the predictions based on PW images by using a
time-to-peak threshold greater than 4 seconds and ADC maps obtained less than 12
hours after middle cerebral artery infarct. ADC- and PW imaging-predicted infarct
growth areas and infarct volumes were correlated with subsequent infarct growth
and follow-up diffusion-weighted (DW) imaging volumes. The impact of MR imaging
time delay on the correlation coefficient between the predicted and subsequent
infarct volumes and individual predictions of infarct growth by using receiver
operating characteristic curves were assessed.
RESULTS: The infarct volume measurements were highly reproducible (concordance
correlation coefficient [CCC] of 0.965 and 95% confidence interval [CI]: 0.949,
0.976 for acute DW imaging; CCC of 0.995 and 95% CI: 0.993, 0.997 for subacute DW
imaging). The subsequent infarct volume correlated (P