Significance of arterial spin labeling perfusion and susceptibility weighted imaging changes in patients with transient ischemic attack: a prospective cohort study
Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
Standard
Significance of arterial spin labeling perfusion and susceptibility weighted imaging changes in patients with transient ischemic attack : a prospective cohort study. / Havsteen, Inger; Willer, Lasse; Ovesen, Christian; Nybing, Janus Damm; Ægidius, Karen; Marstrand, Jacob; Meden, Per; Rosenbaum, Sverre; Folke, Marie Norsker; Christensen, Hanne; Christensen, Anders.
I: BMC Medical Imaging, Bind 18, Nr. 1, 24, 20.08.2018, s. 1-8.Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
Harvard
APA
Vancouver
Author
Bibtex
}
RIS
TY - JOUR
T1 - Significance of arterial spin labeling perfusion and susceptibility weighted imaging changes in patients with transient ischemic attack
T2 - a prospective cohort study
AU - Havsteen, Inger
AU - Willer, Lasse
AU - Ovesen, Christian
AU - Nybing, Janus Damm
AU - Ægidius, Karen
AU - Marstrand, Jacob
AU - Meden, Per
AU - Rosenbaum, Sverre
AU - Folke, Marie Norsker
AU - Christensen, Hanne
AU - Christensen, Anders
PY - 2018/8/20
Y1 - 2018/8/20
N2 - BACKGROUND: In a prospective cohort of patients with transient ischemic attack (TIA), we investigated usefulness and feasibility of arterial spin labeling (ASL) perfusion and susceptibility weighted imaging (SWI) alone and in combination with standard diffusion weighted (DWI) imaging in subacute diagnostic work-up. We investigated rates of ASL and SWI changes and their potential correlation to lasting infarction 8 weeks after ictus.METHODS: Patients with TIA underwent 3T-MRI including DWI, ASL and SWI within 72 h of symptom onset. We defined lasting infarction as presence of 8-week MRI T2-fluid attenuated inversion recovery (FLAIR) hyperintensity or atrophy in the area of initial DWI-lesion.RESULTS: We included 116 patients. Diffusion and perfusion together identified more patients with ischemia than either alone (59% vs. 40%, p < 0.0001). The presence of both diffusion and perfusion lesions had the highest rate of 8-week gliosis scars, 65% (p < 0.0001). In white matter, DWI-restriction was the determinant factor for scar development. However, in cortical gray matter half of lesions with perfusion deficit left a scar, while lesions without perfusion change rarely resulted in scars (56% versus 21%, p = 0.03). SWI lesions were rare (6%) and a subset of perfusion lesions. SWI-lesions with DWI-lesions were all located in cortical gray matter and showed high scar rate.CONCLUSIONS: ASL perfusion increased ischemia detection in patients with TIA, and was most useful in conjunction with DWI. ASL was fast, robust and useful in a subacute clinical diagnostic setting. SWI had few positive findings and did not add information.TRIAL REGISTRATION: http://www.clinicaltrials.gov . Unique Identifier NCT01531946 , prospectively registered February 9, 2012.
AB - BACKGROUND: In a prospective cohort of patients with transient ischemic attack (TIA), we investigated usefulness and feasibility of arterial spin labeling (ASL) perfusion and susceptibility weighted imaging (SWI) alone and in combination with standard diffusion weighted (DWI) imaging in subacute diagnostic work-up. We investigated rates of ASL and SWI changes and their potential correlation to lasting infarction 8 weeks after ictus.METHODS: Patients with TIA underwent 3T-MRI including DWI, ASL and SWI within 72 h of symptom onset. We defined lasting infarction as presence of 8-week MRI T2-fluid attenuated inversion recovery (FLAIR) hyperintensity or atrophy in the area of initial DWI-lesion.RESULTS: We included 116 patients. Diffusion and perfusion together identified more patients with ischemia than either alone (59% vs. 40%, p < 0.0001). The presence of both diffusion and perfusion lesions had the highest rate of 8-week gliosis scars, 65% (p < 0.0001). In white matter, DWI-restriction was the determinant factor for scar development. However, in cortical gray matter half of lesions with perfusion deficit left a scar, while lesions without perfusion change rarely resulted in scars (56% versus 21%, p = 0.03). SWI lesions were rare (6%) and a subset of perfusion lesions. SWI-lesions with DWI-lesions were all located in cortical gray matter and showed high scar rate.CONCLUSIONS: ASL perfusion increased ischemia detection in patients with TIA, and was most useful in conjunction with DWI. ASL was fast, robust and useful in a subacute clinical diagnostic setting. SWI had few positive findings and did not add information.TRIAL REGISTRATION: http://www.clinicaltrials.gov . Unique Identifier NCT01531946 , prospectively registered February 9, 2012.
KW - Aged
KW - Diffusion Magnetic Resonance Imaging/methods
KW - Feasibility Studies
KW - Female
KW - Humans
KW - Ischemic Attack, Transient/diagnostic imaging
KW - Male
KW - Middle Aged
KW - Perfusion Imaging/methods
KW - Prospective Studies
KW - Spin Labels
KW - White Matter/diagnostic imaging
U2 - 10.1186/s12880-018-0264-6
DO - 10.1186/s12880-018-0264-6
M3 - Journal article
C2 - 30126352
VL - 18
SP - 1
EP - 8
JO - BMC Medical Imaging
JF - BMC Medical Imaging
SN - 1471-2342
IS - 1
M1 - 24
ER -
ID: 222251577