Prediction of Infarct Core and Salvageable Ischemic Tissue Volumes by Analyzing Apparent Diffusion Coefficient Without Intravenous Contrast Material
Prediction of Infarct Core and Salvageable Ischemic Tissue Volumes by Analyzing Apparent Diffusion Coefficient Without Intravenous Contrast Material
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DOI：
10.1016/j.acra.2010.07.010
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发表时间：
2010-12-01
影响因子：
4.8
通讯作者：
Chen, Wei-Jian
中科院分区：
文献类型：
--
作者：
Ma, Li;Gao, Pei-Yi;Chen, Wei-Jian
基本原理和目标：为了探讨基线表观扩散系数（ADC）地图是否可以用来预测梗死核心和可挽救的缺血组织体积在急性缺血性stroke.Materials和方法：一个自动图像分析系统的基础上基线ADC地图进行了测试，对30例急性缺血性中风的前循环预测梗死核心和可挽救的缺血组织体积。分别将再通组和未再通组的预测梗死核心和预测可挽救缺血组织与随访成像数据进行定量和定性比较。还与灌注和弥散加权磁共振成像测量进行了直接比较。结果：在再通组，预测的梗死核心体积与最终梗死体积显著相关（r = 0.868，P <0.001）。在无再通组中，预测的最终梗死体积（预测的梗死核心和可挽救的缺血组织体积之和）以及预测的可挽救的缺血组织体积也分别与真实的最终梗死体积（r = 0.955，P <0.001）和梗死生长（r = 0.918，P <0.001）显著相关。灌注扩散不匹配的体积明显大于梗死生长的体积，并预测可挽救的缺血组织。Bland-Altman图显示两组中预测的和真实的最终梗死病变之间的良好一致性。直接的视觉比较分析显示，真正的最终梗死和预测病变之间的定性协议在21 patients.Conclusion：建议ADC为基础的方法可能是一个可行的和实用的工具来预测梗死核心和可挽救的缺血组织的体积没有静脉造影剂增强灌注加权成像在基线。
Rationale and Objectives: To investigate whether baseline apparent diffusion coefficient (ADC) maps can be employed to predict both infarct core and salvageable ischemic tissue volumes in acute ischemic stroke.Materials and Methods: An automated image analysis system based on baseline ADC maps was tested against 30 patients with acute ischemic stroke of anterior circulation to predict both infarct core and salvageable ischemic tissue volumes. The predicted infarct core and predicted salvageable ischemic tissue were quantitatively and qualitatively compared with follow-up imaging data in recanalization and no recanalization groups, respectively. Direct comparisons with perfusion- and diffusion-weighted magnetic resonance imaging measures were also made. Wilcoxon signed-rank test, Spearman rank correlation, and Bland-Altman plots were performed.Results: In the recanalization group, the predicted infarct core volume was significantly correlated with the final infarct volume (r = 0.868, P < .001). In the no recanalization group, the predicted final infarct volume (sum of the predicted infarct core and salvageable ischemic tissue volumes), as well as the predicted salvageable ischemic tissue volume, was also significantly correlated with the true final infarct volume (r = 0.955, P < .001) and infarct growth (r = 0.918, P < .001), respectively. The volumes of perfusion-diffusion mismatch were significantly larger than those of infarct growth and predicted salvageable ischemic tissue. Good agreement between predicted and true final infarct lesions was visualized by Bland-Altman plots in two groups. Direct visual comparative analysis revealed good qualitative agreement between the true final infarct and predicted lesions in 21 patients.Conclusion: The proposed ADC based approach may be a feasible and practical tool to predict the volumes of infarct core and salvageable ischemic tissue without intravenous contrast media-enhanced perfusion-weighted imaging at baseline.