In:
Cerebrovascular Diseases, S. Karger AG, Vol. 46, No. 1-2 ( 2018), p. 16-23
Abstract:
〈 b 〉 〈 i 〉 Background: 〈 /i 〉 〈 /b 〉 In acute stroke, the magnetic resonance (MR) imaging-based mismatch concept is used to select patients with tissue at risk of infarction for reperfusion therapies. There is however a controversy if non-deconvolved or deconvolved perfusion weighted (PW) parameter maps perform better in tissue at risk prediction and which parameters and thresholds should be used to guide treatment decisions. 〈 b 〉 〈 i 〉 Methods: 〈 /i 〉 〈 /b 〉 In a group of 22 acute stroke patients with consecutive MR and quantitative positron emission tomography (PET) imaging, non-deconvolved parameters were validated with the gold standard for penumbral-flow (PF) detection 〈 sup 〉 15 〈 /sup 〉 O-water PET. Performance of PW parameters was assessed by a receiver operating characteristic curve analysis to identify the accuracy of each PWI map to detect the upper PF threshold as defined by PET cerebral blood flow & #x3c;20 mL/100 g/min. 〈 b 〉 〈 i 〉 Results: 〈 /i 〉 〈 /b 〉 Among normalized non-deconvolved parameters, PW-first moment without delay correction (FM without DC) & #x3e; 3.6 s (area under the curve [AUC] = 0.89, interquartile range [IQR] 0.85–0.94), PW-maximum of the concentration curve (Cmax) & #x3c; 0.66 (AUC = 0.92, IQR 0.84–0.96) and PW-time to peak (TTP) & #x3e; 4.0 s (AUC = 0.92, IQR 0.87–0.94) perform significantly better than other non-deconvolved parameters to detect the PF threshold as defined by PET. 〈 b 〉 〈 i 〉 Conclusions: 〈 /i 〉 〈 /b 〉 Non-deconvolved parameters FM without DC, Cmax and TTP are an observer-independent alternative to established deconvolved parameters (e.g., Tmax) to guide treatment decisions in acute stroke.
Type of Medium:
Online Resource
ISSN:
1015-9770
,
1421-9786
Language:
English
Publisher:
S. Karger AG
Publication Date:
2018
detail.hit.zdb_id:
1482069-9
