A Comparison of T2 Relaxation-Based MRI Stroke Timing Methods in Hyperacute Ischemic Stroke Patients: A Pilot Study.
Background: T2 relaxation-based magnetic resonance imaging (MRI) signals may provide onset time for acute ischemic strokes with an unknown onset. The ability of visual and quantitative MRI-based methods in a cohort of hyperacute ischemic stroke patients was studied. Methods: A total of 35 patients u...
| Published in: | Journal of Central Nervous System Disease pp. 1 - 14 |
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| Main Authors: | , , , , , , , , , , |
| Format: | diagnostic images equations & formulas research tables/charts Journal Article |
| Published: |
Sage Publications Inc.
9/12/2020
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| Online Access: | View this record in EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=145713903&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 145713903 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 11795735 B3L8 jtl: Journal of Central Nervous System Disease issn: 11795735 maglogo: Y pubinfo: dt: 9/12/2020 pid: 344 pub: Sage Publications Inc. place: Thousand Oaks, California artinfo: ui: 145713903 145713903 145713903 10.1177/1179573520943314 145713903 ppf: 1 ppct: 13 formats: fmt: – @attributes: type: T – @attributes: type: P tig: atl: A Comparison of T2 Relaxation-Based MRI Stroke Timing Methods in Hyperacute Ischemic Stroke Patients: A Pilot Study. aug: au: McGarry, Bryony L Damion, Robin A Chew, Isabel Knight, Michael J Harston, George WJ Carone, Davide Jezzard, Peter Sitaram, Amith Muir, Keith W Clatworthy, Philip Kauppinen, Risto A affil: School of Psychological Science, University of Bristol, Bristol, UK sug: subj: Magnetic Resonance Imaging Methods Stroke Etiology Stroke Patients Human Pilot Studies ROC Curve Sensitivity and Specificity Thrombosis Signal Processing, Computer Assisted Image Processing, Computer Assisted Data Analysis Software Descriptive Statistics Aged Aged: 65+ years ab: Background: T2 relaxation-based magnetic resonance imaging (MRI) signals may provide onset time for acute ischemic strokes with an unknown onset. The ability of visual and quantitative MRI-based methods in a cohort of hyperacute ischemic stroke patients was studied. Methods: A total of 35 patients underwent 3T (3 Tesla) MRI (<9-hour symptom onset). Diffusion-weighted (DWI), apparent diffusion coefficient (ADC), T1-weighted (T1w), T2-weighted (T2w), and T2 relaxation time (T2) images were acquired. T2-weighted fluid attenuation inversion recovery (FLAIR) images were acquired for 17 of these patients. Image intensity ratios of the average intensities in ischemic and non-ischemic reference regions were calculated for ADC, DWI, T2w, T2 relaxation, and FLAIR images, and optimal image intensity ratio cut-offs were determined. DWI and FLAIR images were assessed visually for DWI/FLAIR mismatch. Results: The T2 relaxation time image intensity ratio was the only parameter with significant correlation with stroke duration (r = 0.49, P =.003), an area under the receiver operating characteristic curve (AUC = 0.77, P <.0001), and an optimal cut-off (T2 ratio = 1.072) that accurately identified patients within the 4.5-hour thrombolysis treatment window with sensitivity of 0.74 and specificity of 0.74. In the patients with the additional FLAIR, areas under the precision-recall-gain curve (AUPRG) and F1 scores showed that the T2 relaxation time ratio (AUPRG = 0.60, F1 = 0.73) performed considerably better than the FLAIR ratio (AUPRG = 0.39, F1 = 0.57) and the visual DWI/FLAIR mismatch (F1 = 0.25). Conclusions: Quantitative T2 relaxation time is the preferred MRI parameter in the assessment of patients with unknown onset for treatment stratification. pubtype: Academic Journal doctype: diagnostic images equations & formulas research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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