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01-08-2021 | Stroke | Neuro

Quantitative susceptibility-weighted imaging may be an accurate method for determining stroke hypoperfusion and hypoxia of penumbra

Authors: Xiudi Lu, Linglei Meng, Yongmin Zhou, Shaoshi Wang, Miller Fawaz, Meiyun Wang, E. Mark Haacke, Chao Chai, Meizhu Zheng, Jinxia Zhu, Yu Luo, Shuang Xia

Published in: European Radiology | Issue 8/2021

Abstract

Objectives

To quantitatively evaluate the volume of the ischemic penumbra using susceptibility-weighted imaging and mapping (SWIM) of asymmetrical prominent cortical veins (APCVs) in patients with acute ischemic stroke.

Methods

Eighty-five eligible patients with acute ischemic stroke on admission within 12 h from symptom onset were studied. The APCVs on SWIM were quantitatively (SWI-volume) and semi-quantitatively (SWI-Alberta Stroke Program Early CT Score, SWI-ASPECTS) evaluated to calculate mismatch. To assess the diagnostic efficacy of APCVs on SWIM, comparative analyses were performed between SWI_volume-DWI mismatch and SWI_ASPECTS-DWI mismatch, using PWI-DWI mismatch as a reference. Correlations were calculated between the mismatches, as well as between SWI-volume and time-to-maximum (Tmax) > 6 s volume. Additionally, each of these mismatches was correlated with the National Institute of Health Stroke Scale (NIHSS).

Results

The sensitivity, negative predictive value, and accuracy of SWI_volume-DWI mismatch were demonstrably higher than SWI_ASPECTS-DWI mismatch (100% vs. 53.7%, 100% vs. 9.5%, 97.7% vs. 54.5%, respectively). A significant positive correlation was found between SWI_volume-DWI and PWI-DWI mismatch (r = 0.691, p < 0.01), as well as between SWI-volume and Tmax > 6 s volume (r = 0.786, p < 0.001). A significant negative correlation was found between SWI_volume-DWI mismatch and NIHSS (r = − 0.360, p = 0.022), as well as between SWI_ASPECTS-DWI mismatch and NIHSS (r = − 0.499, p = 0.001).

Conclusions

SWI_volume-DWI mismatch had higher diagnostic efficacy than SWI_ASPECTS-DWI mismatch in defining the ischemic penumbra and showed good consistency with PWI-DWI mismatch in acute ischemic stroke. Quantitation of APCVs using SWIM provided an accurate method for determining hypoperfusion and provided a reliable method to reflect the hypoxia of penumbra.

Key Points

• SWI _volume -DWI mismatch has higher diagnostic efficacy than SWI _ASPECTS -DWI mismatch in defining the ischemic penumbra.

• SWI _volume -DWI mismatch shows good consistency with PWI-DWI mismatch in managing penumbra in acute ischemic stroke.

• Quantitation of APCV volume using SWIM provided an accurate method for determining the hypoperfusion area and provided a reliable method to reflect the hypoxia of penumbra.

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Title: Quantitative susceptibility-weighted imaging may be an accurate method for determining stroke hypoperfusion and hypoxia of penumbra
Authors: Xiudi Lu
Linglei Meng
Yongmin Zhou
Shaoshi Wang
Miller Fawaz
Meiyun Wang
E. Mark Haacke
Chao Chai
Meizhu Zheng
Jinxia Zhu
Yu Luo
Shuang Xia
Publication date: 01-08-2021
Publisher: Springer Berlin Heidelberg
Keyword: Stroke
Published in: European Radiology / Issue 8/2021
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI: https://doi.org/10.1007/s00330-020-07485-2

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Quantitative susceptibility-weighted imaging may be an accurate method for determining stroke hypoperfusion and hypoxia of penumbra

Abstract

Objectives

Methods

Results

Conclusions

Key Points

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Objectives

Methods

Results

Conclusions

Key Points

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