cnm ‐Positive Streptococcus mutans and diffusion‐weighted imaging hyperintensities in acute intracerebral hemorrhage

2021 ◽  
Author(s):  
Yuji Shiga ◽  
Shiro Aoki ◽  
Naohisa Hosomi ◽  
Ryota Nomura ◽  
Masahiro Nakamori ◽  
...  
Keyword(s):  
Intracerebral Hemorrhage ◽  
Streptococcus Mutans ◽  
Diffusion Weighted Imaging ◽  
Diffusion Weighted ◽  
Acute Intracerebral Hemorrhage ◽  
And Diffusion

Abstract 18: Diffusion Weighted Imaging Lesions in Patients With Acute Intracerebral Hemorrhage: A Pooled Analysis of Individual Patient Data From MISTIE-III, ATACH-II, I-DEF, and ERICH

Stroke ◽  
2020 ◽  
Vol 51 (Suppl_1) ◽  
Author(s):  
Santosh B Murthy ◽  
Sung-Min Cho ◽  
Ajay Gupta ◽  
Ashkan Shoamanesh ◽  
Radhika Avadhani ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Intracerebral Hemorrhage ◽  
Diffusion Weighted Imaging ◽  
Individual Patient Data ◽  
Mixed Effects ◽  
Patient Data ◽  
Factors Associated ◽  
Diffusion Weighted ◽  
Younger Age ◽  
Acute Intracerebral Hemorrhage

Introduction: The etiology and significance of diffusion weighted imaging (DWI) lesions in patients with acute intracerebral hemorrhage (ICH) remain unclear. We evaluated which factors were associated with DWI lesions, whether associated factors differed by ICH location, and whether DWI lesions were associated with functional outcomes. Methods: We pooled individual patient data from the MISTIE III trial, the ATACH-II trial, the i-DEF trial, and the ERICH study. We included only patients who underwent protocolized magnetic resonance imaging (MRI) of the brain. A poor functional outcome was defined as a modified Rankin Scale (mRS) score of 4-6 at 3-6 months. We used mixed effects logistic regression with the study database as a random effect. Results: Among 1,775 ICH patients, there were 621 (35.6%) lobar, 978 (55.9%) deep, and 148 (8.5%) infratentorial ICHs. Median time to MRI scan was 1.5 days (IQR, 1-4). DWIHLs occurred in 559 (31.5%) patients, with 190 (34.3%) in lobar ICH and 320 (57.8%) in deep ICHs. In mixed effects regression models, factors associated with DWIHLs included younger age factors associated with DWIHLs after acute ICH included younger age (OR, 0.98; 95% CI, 0.97-0.99), black race (OR, 1.59; 95% CI, 1.18-2.16), admission systolic blood pressure (SBP per 10 mm Hg, OR, 1.13; 95% CI, 1.05-1.22), cerebral microbleeds (OR, 1.71, 95% CI, 1.24-2.35), and leukoaraiosis (OR, 1.60; 95% CI, 1.14-2.25). Patients with DWIHLs had higher odds of mRS 4-6 (OR, 1.57; 95% CI, 1.24-1.99) compared to those without, after adjustment for demographics and ICH severity. In subgroup analyses, similar factors influenced DWIHLs in deep ICH. However, in lobar ICH, younger age, admission SBP, and leukoaraiosis were associated with DWIHLs. Presence of DWIHLs was independently associated with poor mRS in deep ICH but not in lobar ICH. There was no relationship between acute BP lowering and DWIHLs, regardless of location. Conclusions: In a large, heterogeneous cohort of ICH patients, our results are consistent with the hypothesis that DWIHLs represent the effects of chronic hypertensive vasculopathy and acute blood pressure elevation. Furthermore, DWIHLs portend poor prognosis after ICH, particularly in deep hemorrhages.

scholarly journals Diffusion-Weighted Imaging Hyperintensities in Subtypes of Acute Intracerebral Hemorrhage

Stroke ◽  
2019 ◽  
Vol 50 (1) ◽  
pp. 135-142 ◽  
Author(s):  
Marion Boulanger ◽  
Romain Schneckenburger ◽  
Claire Join-Lambert ◽  
David J. Werring ◽  
Duncan Wilson ◽  
...  
Keyword(s):  
Intracerebral Hemorrhage ◽  
Diffusion Weighted Imaging ◽  
Diffusion Weighted ◽  
Acute Intracerebral Hemorrhage

scholarly journals A Pooled Analysis of Diffusion-Weighted Imaging Lesions in Patients With Acute Intracerebral Hemorrhage

2020 ◽  
Vol 77 (11) ◽  
pp. 1390
Author(s):  
Santosh B. Murthy ◽  
Sung-Min Cho ◽  
Ajay Gupta ◽  
Ashkan Shoamanesh ◽  
Babak B. Navi ◽  
...  
Keyword(s):  
Intracerebral Hemorrhage ◽  
Diffusion Weighted Imaging ◽  
Pooled Analysis ◽  
Diffusion Weighted ◽  
Acute Intracerebral Hemorrhage

The Added Value of Inflow-Based Vascular-Space-Occupancy and Diffusion-Weighted Imaging in Preoperative Grading of Gliomas

2021 ◽  
pp. 1-8
Author(s):  
Haimei Cao ◽  
Xiang Xiao ◽  
Jun Hua ◽  
Guanglong Huang ◽  
Wenle He ◽  
...  
Keyword(s):  
Diagnostic Accuracy ◽  
Roc Curve ◽  
Diffusion Weighted Imaging ◽  
Low Grade ◽  
High Grade ◽  
Mr Images ◽  
Vascular Space ◽  
Diffusion Weighted ◽  
High Grade Gliomas ◽  
And Diffusion

Objectives: The present study aimed to study whether combined inflow-based vascular-space-occupancy (iVASO) MR imaging (MRI) and diffusion-weighted imaging (DWI) improve the diagnostic accuracy in the preoperative grading of gliomas. Methods: Fifty-one patients with histopathologically confirmed diffuse gliomas underwent preoperative structural MRI, iVASO, and DWI. We performed 2 qualitative consensus reviews: (1) structural MR images alone and (2) structural MR images with iVASO and DWI. Relative arteriolar cerebral blood volume (rCBVa) and minimum apparent diffusion coefficient (mADC) were compared between low-grade and high-grade gliomas. Receiver operating characteristic (ROC) curve analysis was performed to compare the tumor grading efficiency of rCBVa, mADC, and the combination of the two parameters. Results: Two observers diagnosed accurate tumor grade in 40 of 51 (78.4%) patients in the first review and in 46 of 51 (90.2%) in the second review. Both rCBVa and mADC showed significant differences between low-grade and high-grade gliomas. ROC analysis gave a threshold value of 1.52 for rCBVa and 0.85 × 10−3 mm2/s for mADC to provide a sensitivity and specificity of 88.0 and 81.2% and 100.0 and 68.7%, respectively. The area under the ROC curve (AUC) was 0.87 and 0.85 for rCBVa and mADC, respectively. The combination of rCBVa and mADC values increased the AUC to 0.92. Conclusion: The combined application of iVASO and DWI may improve the diagnostic accuracy of glioma grading.

scholarly journals The role of magnetic resonance cholangiopancreatography and diffusion-weighted imaging for the differential diagnosis of obstructive biliary disorders

2017 ◽  
Vol 21 (1) ◽  
Author(s):  
Zeynep Cetiner-Alpay ◽  
Fatma Kulali ◽  
Aslihan Semiz-Oysu ◽  
Yasar Bukte ◽  
Kamil Ozdil
Keyword(s):  
Magnetic Resonance ◽  
Sensitivity And Specificity ◽  
Gold Standard ◽  
Diffusion Weighted Imaging ◽  
Magnetic Resonance Cholangiopancreatography ◽  
Malignant Tumours ◽  
Diagnostic Efficacy ◽  
Diffusion Weighted ◽  
Sensitivity Specificity ◽  
And Diffusion

Background: Although endoscopic retrograde cholangiopancreatography (ERCP) is accepted as the gold standard, there is a place for magnetic resonance cholangiopancreatography (MRCP) and diffusion-weighted imaging (DWI) in the diagnosis of obstructive biliary disorders.Aim: To compare the findings of MRCP with ERCP in patients with obstructive biliary disorders and to investigate the diagnostic efficacy of MRCP combined with DWI.Study design: Retrospective, analytic, cross-sectional study.Methods: The MRCP images of 126 patients who underwent both MRCP and ERCP owing to biliary obstruction were reviewed. Nine patients were excluded because of incomplete diagnostic workup or a long period (>3 months) between MRCP and ERCP. Ninety-two patients underwent DWI, which was also evaluated. The sensitivity, specificity and accuracy of MRCP and DWI were analysed.Results: The sensitivity, specificity and accuracy of MRCP according to ERCP results as the gold standard was 97%, 71% and 93% for assessment of biliary dilatation; 100%, 94.7% and 97.5% for the diagnosis of choledocholithiasis; 93.7%, 100% and 99% for the identification of benign strictures; 100%, 100% and 100% for the diagnosis of malignant tumours; and 100%, 100% and 100% for the detection of complicated hydatid cysts; respectively. The sensitivity and specificity of DWI for the diagnosis of malignant tumour was 100%. In the detection of choledocholithiasis, the sensitivity and specificity of DWI was 70.8% and 100%.Conclusions: MRCP is an alternative, non-invasive, diagnostic modality, comparable with ERCP for the evaluation of pancreaticobiliary diseases. DWI can be helpful for diagnosis of choledocholithiasis and tumours.

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