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Erschienen in: Clinical Neuroradiology 1/2019

19.10.2017 | Original Article

Diffusion-Weighted MRI Stroke Volume Following Recanalization Treatment is Threshold-Dependent

verfasst von: Rani Gupta Sah, Christopher D. d’Esterre, Michael D. Hill, Moiz Hafeez, Sana Tariq, Nils D. Forkert, Andrew M. Demchuk, Mayank Goyal, Philip A. Barber

Erschienen in: Clinical Neuroradiology | Ausgabe 1/2019

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Abstract

Purpose

Infarct lesion segmentation has been problematic as there are a wide range of relative and absolute diffusion-weighted imaging (DWI) and apparent diffusion coefficient (ADC) thresholds that have been used for this purpose. We examined differences of stroke lesion volume and evolution evaluated by magnetic resonance imaging (MRI) during the immediate post-treatment phase (<5 h) and at 24 h.

Methods

In this study 33 acute ischemic stroke patients were imaged with MRI <5 h and 24 h post-reperfusion treatment. Lesion volumes were segmented on ADC maps and average DWI using literature cited absolute ADC and relative DWI thresholds. The segmented lesion volumes within both time points were compared and the absolute change in lesion volume (infarct growth) between the two time points was calculated and compared using Bland-Altman analysis.

Results

Lesion volumes differed significantly when different relative DWI or absolute ADC thresholds were used (p < 0.05), which held true for baseline as well as follow-up lesions. The median absolute changes in lesion volume from baseline to follow-up for ADC thresholds of 550 × 10−6 mm2/s, 600 × 10−6 mm2/s, 630 × 10−6 mm2/s and 650 × 10−6 mm2/s were 3.5 ml, 4.2 ml, 4.5 ml, and 6.5 ml, respectively (p < 0.05). Likewise, the median absolute changes in lesion volume from baseline to follow-up for DWI thresholds, k = 0.85, 1.28, 1.64, 1.96, and 2.7 were 10.1 ml, 7.3 ml, 5.7 ml, 5.4 ml and 4.2 ml, respectively (p < 0.05).

Conclusion

Absolute lesion volumes and changes in lesion volumes (infarct growth) measured after recanalization treatment were dependent on absolute ADC and relative DWI thresholds, which may have clinical significance. Standardization of techniques for measuring DWI lesion volumes requires immediate attention.
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Metadaten
Titel
Diffusion-Weighted MRI Stroke Volume Following Recanalization Treatment is Threshold-Dependent
verfasst von
Rani Gupta Sah
Christopher D. d’Esterre
Michael D. Hill
Moiz Hafeez
Sana Tariq
Nils D. Forkert
Andrew M. Demchuk
Mayank Goyal
Philip A. Barber
Publikationsdatum
19.10.2017
Verlag
Springer Berlin Heidelberg
Erschienen in
Clinical Neuroradiology / Ausgabe 1/2019
Print ISSN: 1869-1439
Elektronische ISSN: 1869-1447
DOI
https://doi.org/10.1007/s00062-017-0634-4

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