Classification of lesion area in stroke patients during the subacute Phase: a multiparametric MRI study

TY - JOUR

T1 - Classification of lesion area in stroke patients during the subacute Phase: a multiparametric MRI study

AU - Artzi, Moran

AU - Aizenstein, Orna

AU - Jonas-Kimchi, Tali

AU - Bornstein, Natan

AU - Shopin, Ludmila

AU - Hallevi, Hen

AU - Ben Bashat, Dafna

AU - STIR/VISTA Imaging Collaboration

AU - Thomalla, Götz

N1 - Copyright © 2013 Wiley Periodicals, Inc.

PY - 2014/11/1

Y1 - 2014/11/1

N2 - PURPOSE: Stroke imaging studies during the acute phase are likely to precede several vascular brain mechanisms, which have an important role in patient outcome. The aim of this study was to identify within the lesion area during the subacute phase (≥1 day) reactive tissue, which may have the potential for recovery.METHODS: Twenty seven stroke patients from two cohorts were included. MRI performed during the subacute phase included conventional, perfusion and diffusion imaging. In cohort I, unsupervised multiparametric classification of the lesion area was performed. In cohort II threshold based classification was performed during the subacute phase, and radiological outcome was assessed at follow-up scan.RESULTS: Three tissue classes were identified in cohort I, referred to as irreversibly damaged, intermediary, and reactive tissue. Based on threshold values defined in cohort I, the reactive tissue was identified in 11/13 patients in cohort II, and showed tissue preservation/partial recovery in 9/11 patients at follow-up scan. The irreversibly damaged tissue was identified in 7/13 patients in cohort II, and predicted tissue necrosis in all cases.CONCLUSION: Identification of reactive tissue following stroke during the subacute phase can improve radiological assessment, contribute to the understanding of brain recovery processes and has implications for new therapeutic approaches.

AB - PURPOSE: Stroke imaging studies during the acute phase are likely to precede several vascular brain mechanisms, which have an important role in patient outcome. The aim of this study was to identify within the lesion area during the subacute phase (≥1 day) reactive tissue, which may have the potential for recovery.METHODS: Twenty seven stroke patients from two cohorts were included. MRI performed during the subacute phase included conventional, perfusion and diffusion imaging. In cohort I, unsupervised multiparametric classification of the lesion area was performed. In cohort II threshold based classification was performed during the subacute phase, and radiological outcome was assessed at follow-up scan.RESULTS: Three tissue classes were identified in cohort I, referred to as irreversibly damaged, intermediary, and reactive tissue. Based on threshold values defined in cohort I, the reactive tissue was identified in 11/13 patients in cohort II, and showed tissue preservation/partial recovery in 9/11 patients at follow-up scan. The irreversibly damaged tissue was identified in 7/13 patients in cohort II, and predicted tissue necrosis in all cases.CONCLUSION: Identification of reactive tissue following stroke during the subacute phase can improve radiological assessment, contribute to the understanding of brain recovery processes and has implications for new therapeutic approaches.

U2 - 10.1002/mrm.25031

DO - 10.1002/mrm.25031

M3 - SCORING: Journal article

C2 - 24243644

VL - 72

SP - 1381

EP - 1388

JO - MAGN RESON MED

JF - MAGN RESON MED

SN - 0740-3194

IS - 5

ER -