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首页> 外文期刊>American Journal of Neuroradiology >Diffusion-Weighted MR Imaging in Acute Ischemia: Value of Apparent Diffusion Coefficient and Signal Intensity Thresholds in Predicting Tissue at Risk and Final Infarct Size
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Diffusion-Weighted MR Imaging in Acute Ischemia: Value of Apparent Diffusion Coefficient and Signal Intensity Thresholds in Predicting Tissue at Risk and Final Infarct Size

机译：急性缺血时弥散加权MR成像：预测危险和最终梗死面积的组织中明显的弥散系数和信号强度阈值

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BACKGROUND AND PURPOSE: Identifying tissue at risk for infarction is an important goal of stroke imaging. This study was performed to determine whether pixel-based apparent diffusion coefficient (ADC) and signal intensity ratio are helpful diffusion-weighted (DW) imaging metrics to predict tissue at risk for infarction. METHODS: Twelve patients presenting with acute hemispheric strokes underwent DW imaging within 7 hours of symptom onset. Region of interest (ROI), pixel-based ADC, and signal intensity analyses were performed at initial DW imaging to assess area of infarct growth, final infarct area, and normal tissue. RESULTS: Pixel-based analysis was less accurate than ROI-based analysis for evaluating infarct growth or final infarct with ADC, ADC ratio, and signal intensity ratios. In pixel-based analysis, signal intensity ratios were better than ADCs or ADC ratios for identifying tissue at risk (accuracy, 67.4%) and for predicting final infarct (accuracy, 79.9%). Linear regression analysis demonstrated a strong correlation between lesion volume on quantitative DW images or ADC maps and final infarct volume (P < .001). When receiver operating characteristic (ROC) curves were used to determine optimal cutoffs for ADC and DW image values, the region of infarct growth was significantly correlated with only the mismatch between initial qualitative DW image and quantitative DW image signal intensity ratio (cutoff value, 1.19; R = 0.652; P = .022). CONCLUSION: Pixel-based thresholds applied to ADC or DW image signal intensity maps were not accurate prognostic measures of tissue at risk. Quantitative DW images or ADC maps may provide added information not obtained by visual inspection of the qualitative DW image map.
机译：背景与目的：识别有梗塞危险的组织是卒中影像学的重要目标。 进行了这项研究，以确定基于像素的视在扩散系数 （ADC）和信号强度比是否对扩散加权 （DW）成像有帮助方法来预测有梗死危险的组织。 方法：十二名急性半球卒中 的患者在症状发作后7小时内进行了DW成像。在初始DW成像时执行感兴趣的区域 （ROI），基于像素的ADC和信号强度分析 ，以评估梗死区的面积，结果：基于像素的分析比使用基于ROI的 分析评估梗死增长或使用 ADC，ADC比和信号强度比。在基于像素的 分析中，信号强度比优于ADC或ADC 比率来识别有风险的组织（准确性为67.4％），而 预测最终的梗塞（准确性，为79.9％）。线性回归 分析表明定量DW图像或ADC映射上的病变体积 与最终梗死体积 之间具有很强的相关性（P <.001）。当使用接收器工作特性（ROC） 曲线确定ADC和DW 图像值的最佳截止值时，梗塞生长区域显着相关。仅初始定性 DW图像和定量DW图像信号强度比之间的不匹配（cutoff 值，1.19; R = 0.652; P = .022）。 / sup>结论：应用于ADC或DW图像 信号强度图的基于像素的阈值并不是对处于风险中的组织的准确的预后措施。定量DW图像或ADC映射可能会提供 附加信息，这些信息不是通过目视检查定性 DW图像映射获得的。

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    《American Journal of Neuroradiology》 |2004年第8期|00001331-00001336|共6页
  • 作者

    Dong Gyu Na; Vincent N. Thijs; Gregory W. Albers; Michael E. Moseley; Michael P. Marks;

  • 作者单位

    Department of Radiology, Stanford University Medical Center, Stanford, CA|Department of Radiology, Seoul National University Hospital, Seoul, Korea;

    Department of Neurology, Stanford University Medical Center, Stanford, CA;

    Department of Neurology, Stanford University Medical Center, Stanford, CA;

    Department of Radiology, Stanford University Medical Center, Stanford, CA;

    Department of Radiology, Stanford University Medical Center, Stanford, CA|Department of Neurosurgery, Stanford University Medical Center, Stanford, CA;

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