- Title
- Optimal magnetic resonance perfusion thresholds identifying ischemic penumbra and infarct core: a Chinese population-based study
- Creator
- Zhang, Sheng; Tang, Huan; Yu, Yan-Nan; Yan, Shen-Qiang; Parsons, Mark W.; Lou, Min
- Relation
- NHMRC
- Relation
- CNS Neuroscience & Therapeutics Vol. 21, Issue 3, p. 289-295
- Publisher Link
- http://dx.doi.org/10.1111/cns.12367
- Publisher
- Wiley-Blackwell
- Resource Type
- journal article
- Date
- 2015
- Description
- Summary: Aims: To validate whether the optimal magnetic resonance perfusion (MRP) thresholds for ischemic penumbra and infarct core, between voxel and volume-based analysis, are varied greatly among Chinese acute ischemic stroke patients. Materials and methods: Acute ischemic stroke patients receiving intravenous thrombolysis within 6 h of onset that obtained acute and 24-h MRP were reviewed. Patients with either no reperfusion (<30% reperfusion at 24 h) or successful reperfusion (>70% reperfusion at 24 h) were enrolled to investigate the ischemic penumbra and infarct core, respectively. The final infarct was assessed on 24-h diffusion-weighted imaging (DWI), which was retrospectively matched to the baseline perfusion-weighted imaging (PWI) images by volume or voxel-based analysis. The optimal thresholds that determined by each approach were compared. Results: From June 2009 to Jan 2014, of 50 patients enrolled, 19 patients achieved no reperfusion, and 20 patients reperfused at 24 h. In patients with no reperfusion, Tmax > 6 seconds was proved of the best agreement with the final infarct in both volumetric analysis (ratio: 1.05, 95% limits of agreement:-0.23 to 2.33, P < 0.001) and voxel-by-voxel analysis (sensitivity: 72.3%, specificity: 74.3%). In patients with reperfusion, rMTT>225% (ratio:2.4, 95% limits of agreement: -6.5 to 11.4, P < 0.001) was found of the best volumetric agreement with the final infarct, while Tmax > 5.6 seconds (sensitivity: 76.8%, specificity: 70.3%) performed most accurately in voxel-based analysis. Conclusion: Among Chinese acute stroke patients, volume of Tmax >6 seconds may precisely target ischemic penumbra tissue as good as voxel-based analysis performed, albeit no concordant MRP parameter is found to accurately predict infarct core because reperfusion occurred within 24 h after thrombolysis fails to restrain the infarct growth.
- Subject
- acute ischemic stroke; magnetic resonance imaging; reperfusion; threshold
- Identifier
- http://hdl.handle.net/1959.13/1332659
- Identifier
- uon:26920
- Identifier
- ISSN:1755-5930
- Language
- eng
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