Comparison of 10 Perfusion MRI Parameters in 97 Sub-6-Hour Stroke Patients Using Voxel-Based Receiver Operating Characteristics Analysis
Comparison of 10 Perfusion MRI Parameters in 97 Sub-6-Hour Stroke Patients Using Voxel-Based Receiver Operating Characteristics Analysis
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DOI：
10.1161/strokeaha.108.546069
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发表时间：
2009-06-01
期刊：
影响因子：
8.3
通讯作者：
Ostergaard, Leif
中科院分区：
文献类型：
--
作者：
Christensen, Soren;Mouridsen, Kim;Ostergaard, Leif
背景和目的-灌注加权成像可以预测急性卒中中梗死的发展，并可能用于选择有再灌注治疗风险的组织患者。然而，缺乏关于如何最好地创建反映风险组织的PWI图的共识和证据，挑战了试验中结果的比较和急性决策。假设使用动脉输入函数的去卷积生成的图具有更定量的性质，并且比简单的汇总测量（如达峰时间或浓度时间曲线的第一时刻）具有更好的预后价值。我们试图比较10个不同的灌注参数，他们的能力，以预测组织梗死在急性缺血性stroke. Methods，在一项回顾性分析的97例急性中风患者的研究在6小时内从症状发作，我们使用接收器的操作特点，在一个基于体素的分析，比较10个灌注参数：达峰时间、一阶矩、脑血容量和流量，以及残差函数和平均通过时间图的达峰时间的6个变量。亚组分析评估再灌注对预后预测的影响。结果最具预测性的地图是总结措施的第一时刻和时间达到峰值。第一时刻是更显着的预测时间比峰值的残余功能和局部动脉输入功能为基础的方法（P < 0.05），但没有显着优于传统的平均通过时间maps.Conclusion-Results表明，如果一个单一的地图类型是用来预测梗死，第一时刻地图至少以及去卷积的措施。去卷积消除了组织灌注的延迟，我们推测这会对梗死预测产生负面影响。（中风。2009; 40：2055-2061.）
Background and Purpose-Perfusion-weighted imaging can predict infarct growth in acute stroke and potentially be used to select patients with tissue at risk for reperfusion therapies. However, the lack of consensus and evidence on how to best create PWI maps that reflect tissue at risk challenges comparisons of results and acute decision-making in trials. Deconvolution using an arterial input function has been hypothesized to generate maps of a more quantitative nature and with better prognostic value than simpler summary measures such as time-to-peak or the first moment of the concentration time curve. We sought to compare 10 different perfusion parameters by their ability to predict tissue infarction in acute ischemic stroke.Methods-In a retrospective analysis of 97 patients with acute stroke studied within 6 hours from symptom onset, we used receiver operating characteristics in a voxel-based analysis to compare 10 perfusion parameters: time-to-peak, first moment, cerebral blood volume and flow, and 6 variants of time to peak of the residue function and mean transit time maps. Subanalysis assessed the effect of reperfusion on outcome prediction.Results-The most predictive maps were the summary measures first moment and time-to-peak. First moment was significantly more predictive than time to peak of the residue function and local arterial input function-based methods (P < 0.05), but not significantly better than conventional mean transit time maps.Conclusion-Results indicated that if a single map type was to be used to predict infarction, first moment maps performed at least as well as deconvolved measures. Deconvolution decouples delay from tissue perfusion; we speculate this negatively impacts infarct prediction. (Stroke. 2009; 40: 2055-2061.)