Your browser doesn't support javascript.
loading
Diffusion-Weighted Imaging and Fluid-Attenuated Inversion Recovery Quantification to Predict Diffusion-Weighted Imaging-Fluid-Attenuated Inversion Recovery Mismatch Status in Ischemic Stroke With Unknown Onset.
Scheldeman, Lauranne; Wouters, Anke; Dupont, Patrick; Christensen, Søren; Boutitie, Florent; Cheng, Bastian; Ebinger, Martin; Endres, Matthias; Fiebach, Jochen B; Gerloff, Christian; Muir, Keith W; Nighoghossian, Norbert; Pedraza, Salvador; Simonsen, Claus Z; Thijs, Vincent; Thomalla, Götz; Lemmens, Robin.
Afiliação
  • Scheldeman L; Department of Neurology, University Hospitals Leuven, Belgium (L.S., A.W., R.L.).
  • Wouters A; Department of Neurosciences, Experimental Neurology (L.S., A.W., R.L.), KU Leuven - University of Leuven, Belgium.
  • Dupont P; Center for Brain and Disease Research, Laboratory of Neurobiology, VIB, Leuven, Belgium (L.S., A.W., R.L.).
  • Christensen S; Department of Neurology, University Hospitals Leuven, Belgium (L.S., A.W., R.L.).
  • Boutitie F; Department of Neurosciences, Experimental Neurology (L.S., A.W., R.L.), KU Leuven - University of Leuven, Belgium.
  • Cheng B; Center for Brain and Disease Research, Laboratory of Neurobiology, VIB, Leuven, Belgium (L.S., A.W., R.L.).
  • Ebinger M; Neurology, Amsterdam University Medical Centers, the Netherlands (A.W.).
  • Endres M; Department of Neurosciences, Laboratory for Cognitive Neurology (P.D.), KU Leuven - University of Leuven, Belgium.
  • Fiebach JB; Leuven Brain Institute, Belgium (P.D.).
  • Gerloff C; GrayNumber Analytics, Lomma, Sweden (S.C.).
  • Muir KW; Hospices Civils de Lyon, Service de Biostatistique, France (F.B.).
  • Nighoghossian N; Université Lyon 1, Villeurbanne, France (F.B.).
  • Pedraza S; Klinik und Poliklinik für Neurologie, Kopf- und Neurozentrum, University Medical Center Hamburg-Eppendorf, Germany (B.C., C.G., G.T.).
  • Simonsen CZ; Center for Stroke Research Berlin (CSB) (M. Ebinger, M. Endres, J.B.F.), Charité - Universitätsmedizin Berlin, Germany.
  • Thijs V; Klinik für Neurologie, Medical Park Berlin Humboldtmühle, Germany (M. Ebinger).
  • Thomalla G; Center for Stroke Research Berlin (CSB) (M. Ebinger, M. Endres, J.B.F.), Charité - Universitätsmedizin Berlin, Germany.
  • Lemmens R; Klinik und Hochschulambulanz für Neurologie (M. Endres), Charité - Universitätsmedizin Berlin, Germany.
Stroke ; 53(5): 1665-1673, 2022 05.
Article em En | MEDLINE | ID: mdl-35105179
ABSTRACT

BACKGROUND:

Visual rating of diffusion-weighted imaging (DWI)-fluid-attenuated inversion recovery (FLAIR) mismatch can be challenging. We evaluated quantification of DWI and FLAIR to predict DWI-FLAIR mismatch status in ischemic stroke.

METHODS:

In screened patients from the WAKE-UP trial (Efficacy and Safety of Magnetic Resonance Imaging-Based Thrombolysis in Wake-Up Stroke), we retrospectively studied relative DWI (rDWI SI) and FLAIR signal intensity (rFLAIR SI). We defined the optimal mean rFLAIR SI and interquartile range of the rDWI SI in the DWI lesion to predict DWI-FLAIR mismatch status. We investigated agreement between each quantitative parameter and the DWI-FLAIR mismatch and the association between both quantitative parameters. We evaluated the predictive value of the quantitative parameters for excellent functional outcome by logistic regression, adjusted for DWI lesion volume, treatment, age, and National Institutes of Health Stroke Scale score.

RESULTS:

In the rFLAIR and rDWI SI analysis, 213/369 and 241/421 subjects respectively had a DWI-FLAIR mismatch. A mean rFLAIR SI cutoff of 1.09 and interquartile range rDWI SI cutoff of 0.47 were optimal to predict the DWI-FLAIR mismatch with a sensitivity and specificity of 77% (95% CI, 71%-83%) and 67% (95% CI, 59%-74%), and 76% (95% CI, 70%-81%) and 72% (95% CI, 65%-79%), respectively. For both quantitative parameters, agreement with the DWI-FLAIR mismatch was fair (73%, κ=0.44 [95% CI, 0.35-0.54] for rFLAIR and 74%, κ=0.48 [95% CI, 0.39-0.56] for rDWI). Both quantitative parameters correlated moderately (Pearson R=0.54 [95% CI, 0.46-0.61]; P<0.001, n=367). The interquartile range rDWI SI (n=188), but not the mean rFLAIR SI (n=172), was an independent predictor of excellent functional outcome (odds ratio, 0.67 per 0.1 unit increase of interquartile range rDWI SI, 95% CI, 0.51-0.89, P=0.01).

CONCLUSIONS:

Agreement between the quantitative and qualitative approach may be insufficient to advocate DWI or FLAIR quantification as alternative for visual rating.
Assuntos
Palavras-chave

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Acidente Vascular Cerebral / AVC Isquêmico Tipo de estudo: Observational_studies / Prognostic_studies / Qualitative_research / Risk_factors_studies Limite: Humans País como assunto: America do norte Idioma: En Ano de publicação: 2022 Tipo de documento: Article

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Acidente Vascular Cerebral / AVC Isquêmico Tipo de estudo: Observational_studies / Prognostic_studies / Qualitative_research / Risk_factors_studies Limite: Humans País como assunto: America do norte Idioma: En Ano de publicação: 2022 Tipo de documento: Article