Quantitative measurements of relative fluid-attenuated inversion recovery (FLAIR) signal intensities in acute stroke for the prediction of time from symptom onset.
J Cereb Blood Flow Metab. 2012-10-10; 33(1): 76-84
DOI: 10.1038/jcbfm.2012.129
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1. J Cereb Blood Flow Metab. 2013 Jan;33(1):76-84. doi: 10.1038/jcbfm.2012.129. Epub
2012 Oct 10.
Quantitative measurements of relative fluid-attenuated inversion recovery (FLAIR)
signal intensities in acute stroke for the prediction of time from symptom onset.
Cheng B(1), Brinkmann M, Forkert ND, Treszl A, Ebinger M, Köhrmann M, Wu O, Kang
DW, Liebeskind DS, Tourdias T, Singer OC, Christensen S, Luby M, Warach S,
Fiehler J, Fiebach JB, Gerloff C, Thomalla G; STIR and VISTA Imaging
Investigators.
Collaborators: Warach S, Albers G, Davis S, Donnan G, Fisher M, Furlan A, Grotta
J, Hacke W, Kang D, Kidwell C, Koroshetz W, Lees KR, Lev M, Liebeskind DS,
Sorensen AG, Thijs V, Thomalla G, Wardlaw J, Wintermark M.
Author information:
(1)Klinik und Poliklinik für Neurologie, Kopf- und Neurozentrum,
Universitätsklinikum Hamburg-Eppendorf, Hamburg, Germany.
In acute stroke magnetic resonance imaging, a ‘mismatch’ between visibility of an
ischemic lesion on diffusion-weighted imaging (DWI) and missing corresponding
parenchymal hyperintensities on fluid-attenuated inversion recovery (FLAIR) data
sets was shown to identify patients with time from symptom onset ≤4.5 hours with
high specificity. However, moderate sensitivity and suboptimal interpreter
agreement are limitations of a visual rating of FLAIR lesion visibility. We
tested refined image analysis methods in patients included in the previously
published PREFLAIR study using refined visual analysis and quantitative
measurements of relative FLAIR signal intensity (rSI) from a three-dimensional,
segmented stroke lesion volume. A total of 399 patients were included. The rSI of
FLAIR lesions showed a moderate correlation with time from symptom onset
(r=0.382, P