Fluid-Attenuated Inversion Recovery Vascular Hyperintensities–Diffusion-Weighted Imaging Mismatch Identifies Acute Stroke Patients Most Likely to Benefit From Recanalization

Stroke ◽  
2016 ◽  
Vol 47 (2) ◽  
pp. 424-427 ◽  
Author(s):  
Laurence Legrand ◽  
Marie Tisserand ◽  
Guillaume Turc ◽  
Myriam Edjlali ◽  
David Calvet ◽  
...  
Keyword(s):  
Acute Stroke ◽  
Diffusion Weighted Imaging ◽  
Inversion Recovery ◽  
Stroke Patients ◽  
Diffusion Weighted ◽  
Fluid Attenuated Inversion Recovery

scholarly journals Clinical characteristics of unknown symptom onset stroke patients with and without diffusion-weighted imaging and fluid-attenuated inversion recovery mismatch

2017 ◽  
Vol 13 (1) ◽  
pp. 66-73 ◽  
Author(s):  
Götz Thomalla ◽  
Florent Boutitie ◽  
Jochen B Fiebach ◽  
Claus Z Simonsen ◽  
Salvador Pedraza ◽  
...  
Keyword(s):  
Symptom Onset ◽  
Diffusion Weighted Imaging ◽  
Clinical Characteristics ◽  
Controlled Trial ◽  
Inversion Recovery ◽  
Stroke Patients ◽  
Unique Identifier ◽  
Symptom Recognition ◽  
Diffusion Weighted ◽  
Fluid Attenuated Inversion Recovery

Background Diffusion-weighted imaging (DWI) and fluid-attenuated inversion recovery (FLAIR) mismatch was suggested to identify stroke patients with unknown time of symptom onset likely to be within the time window for thrombolysis. Aims We aimed to study clinical characteristics associated with DWI-FLAIR mismatch in patients with unknown onset stroke. Methods We analyzed baseline MRI and clinical data from patients with acute ischemic stroke proven by DWI from WAKE-UP, an investigator-initiated, randomized, placebo-controlled trial of MRI-based thrombolysis in stroke patients with unknown time of symptom onset. Clinical characteristics were compared between patients with and without DWI-FLAIR mismatch. Results Of 699 patients included, 418 (59.8%) presented with DWI-FLAIR mismatch. A shorter delay between last seen well and symptom recognition (p = 0.0063), a shorter delay between symptom recognition and arrival at hospital (p = 0.0025), and history of atrial fibrillation (p = 0.19) were predictors of DWI-FLAIR mismatch in multivariate analysis. All other characteristics were comparable between groups. Conclusions There are only minor differences in measured clinical characteristics between unknown symptom onset stroke patients with and without DWI-FLAIR mismatch. DWI-FLAIR mismatch as an indicator of stroke onset within 4.5 h shows no relevant association with commonly collected clinical characteristics of stroke patients. Clinical Trial Registration URL: http://www.clinicaltrials.gov . Unique identifier: NCT01525290; URL: https://www.clinicaltrialsregister.eu . Unique identifier: 2011-005906-32.

Diffusion-Weighted Imaging Volume as the Best Predictor of the Diffusion-Perfusion Mismatch in Acute Stroke Patients within 8 Hours of Onset

2014 ◽  
Vol 25 (2) ◽  
pp. 217-225 ◽  
Author(s):  
Junya Aoki ◽  
Yohei Tateishi ◽  
Christopher L. Cummings ◽  
Esteban Cheng-Ching ◽  
Paul Ruggieri ◽  
...  
Keyword(s):  
Acute Stroke ◽  
Diffusion Weighted Imaging ◽  
Stroke Patients ◽  
Diffusion Weighted

Rhombencephalitis in Children: Diffusion Magnetic Resonance Imaging (MRI) Correlation With Clinical Outcomes

2020 ◽  
Vol 35 (6) ◽  
pp. 404-409
Author(s):  
Alex Mun-Ching Wong ◽  
Chih-Hua Yeh ◽  
Jainn-Jim Lin ◽  
I-Jun Chou ◽  
Kuang-Lin Lin
Keyword(s):  
Clinical Outcomes ◽  
Diffusion Weighted Imaging ◽  
Multivariate Logistic Regression Analysis ◽  
Inversion Recovery ◽  
Unfavorable Outcome ◽  
Multivariate Logistic Regression ◽  
Diffusion Weighted ◽  
Disturbance Of Consciousness ◽  
Outcome Group ◽  
Fluid Attenuated Inversion Recovery

In children with rhombencephalitis, neuroimaging abnormalities have been infrequently correlated with clinical outcome. We investigated whether magnetic resonance (MR) neuroimaging studies could predict clinical outcomes and disturbance of consciousness in patients with rhombencephalitis. We retrospectively analyzed the MR studies of 19 pediatric patients with rhombencephalitis (median age: 4.2 years, range 0.5-17; sex: 32% male). Fluid-attenuated inversion recovery imaging and diffusion-weighted imaging findings were graded to create imaging scores according to the extent of imaging abnormality. Clinical outcomes in the first week and 12th month were graded by using Glasgow Outcome Scale scores (1-5) and dichotomized to unfavorable or favorable outcome. Correlations of the imaging scores with the clinical outcomes and with disturbance of consciousness were assessed by using multivariate logistic regression analysis. No significant correlation was found between fluid-attenuated inversion recovery score or diffusion-weighted imaging score ( P = .608, P = .132, respectively) and disturbance of consciousness. In the first week, the unfavorable outcome group (n = 11) had significantly higher diffusion-weighted imaging score than did the favorable outcome group (n = 8) (Mann-Whitney U test, P = .005). Multivariate logistic regression analysis showed that the diffusion-weighted imaging score (odds ratio, 18.182; 95% confidence interval: 1.36, 243.01; P = .028) was significantly associated with unfavorable outcome. In the 12th month, the fluid-attenuated inversion recovery score or diffusion-weighted imaging score ( P = .994, P = .997, respectively) were not significantly associated with unfavorable outcome. Patients with rhombencephalitis who have a higher diffusion-weighted imaging score are more likely to have an unfavorable 1-week clinical outcome.

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