Computational protocol: Diffusion- and Perfusion-Weighted Imaging in Acute Lacunar Infarction: Is There a Mismatch?

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Protocol publication

[…] Acute ischemic lesions in the basal ganglia, thalamus, internal capsule, corona radiata or brainstem were classified as LI attributable to single perforating artery occlusion if the maximal diameter was < 15 mm on DWI. An underlying large vessel pathology was excluded on MR angiography. Ischemic lesion size was measured on DWI by manually delineated region of interest (ROI), summation of these areas in cm2 on each section and multiplication by the interslice spacing, to determine the volume in cm3 by use of OsiriX, a multidimensional image navigation and display software []. Lesion growth as well as reversal were defined as the difference between the infarction volume on follow-up DWI images and the initial DWI lesion volume.To obtain information about hemodynamic alterations caused by vascular pathology, calculated TTP images demonstrating the delay of the contrast agent arrival in the brain parenchyma were used for visual analysis. Time to peak maps were classified as showing a normal perfusion pattern or areas of hypoperfusion. We defined mismatch as a hypoperfused area on PWI larger than the DWI lesion (PWI>DWI), inverse mismatch as a hypoperfused area smaller than the DWI lesion (PWISPSS) statistics for Windows (Release 17.0; SPSS, Chicago, IL, USA). Comparison of lesion size on DWI and PWI was performed using the student's t-test. Comparison of CBF and CBV ratios as well as hypoperfused brain tissue volumes was performed using the student's t-test. Association of DWI reversal or lesion growth and hypoperfusion as well as treatment with intravenous thrombolysis was analyzed using Fisher's exact test. All statistics was performed with a 0.05 level of significance. […]

Pipeline specifications

Software tools OsiriX, SPSS
Applications Miscellaneous, Magnetic resonance imaging
Organisms Homo sapiens
Diseases Brain Diseases, Brain Ischemia, Stroke