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Neuroradiology

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01-08-2014 | Diagnostic Neuroradiology

Intravoxel incoherent motion perfusion imaging in acute stroke: initial clinical experience

Authors: C. Federau, S. Sumer, F. Becce, P. Maeder, K. O’Brien, R. Meuli, M. Wintermark

Published in: Neuroradiology | Issue 8/2014

Abstract

Introduction

Intravoxel incoherent motion (IVIM) imaging is an MRI perfusion technique that uses a diffusion-weighted sequence with multiple b values and a bi-compartmental signal model to measure the so-called pseudo-diffusion of blood caused by its passage through the microvascular network. The goal of the current study was to assess the feasibility of IVIM perfusion fraction imaging in patients with acute stroke.

Methods

Images were collected in 17 patients with acute stroke. Exclusion criteria were onset of symptoms to imaging >5 days, hemorrhagic transformation, infratentorial lesions, small lesions <0.5 cm in minimal diameter and hemodynamic instability. IVIM imaging was performed at 3 T, using a standard spin-echo Stejskal-Tanner pulsed gradients diffusion-weighted sequence, using 16 b values from 0 to 900 s/mm². Image quality was assessed by two radiologists, and quantitative analysis was performed in regions of interest placed in the stroke area, defined by thresholding the apparent diffusion coefficient maps, as well as in the contralateral region.

Results

IVIM perfusion fraction maps showed an area of decreased perfusion fraction f in the region of decreased apparent diffusion coefficient. Quantitative analysis showed a statistically significant decrease in both IVIM perfusion fraction f (0.026 ± 0.019 vs. 0.056 ± 0.025, p = 2.2 · 10⁻⁶) and diffusion coefficient D compared with the contralateral side (3.9 ± 0.79 · 10⁻⁴ vs. 7.5 ± 0.86 · 10⁻⁴ mm²/s, p = 1.3 · 10⁻²⁰).

Conclusion

IVIM perfusion fraction imaging is feasible in acute stroke. IVIM perfusion fraction is significantly reduced in the visible infarct. Further studies should evaluate the potential for IVIM to predict clinical outcome and treatment response.

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Title: Intravoxel incoherent motion perfusion imaging in acute stroke: initial clinical experience
Authors: C. Federau
S. Sumer
F. Becce
P. Maeder
K. O’Brien
R. Meuli
M. Wintermark
Publication date: 01-08-2014
Publisher: Springer Berlin Heidelberg
Published in: Neuroradiology / Issue 8/2014
Print ISSN: 0028-3940
Electronic ISSN: 1432-1920
DOI: https://doi.org/10.1007/s00234-014-1370-y

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Intravoxel incoherent motion perfusion imaging in acute stroke: initial clinical experience

Abstract

Introduction

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Introduction

Methods

Results

Conclusion

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