7
views
0
recommends
+1 Recommend
0 collections
    0
    shares
      • Record: found
      • Abstract: found
      • Article: not found

      R2* Map by IDEAL IQ for Acute Cerebral Infarction: Compared with Susceptibility Vessel Sign on T2*-Weighted Imaging

      research-article

      Read this article at

      ScienceOpenPMC
      Bookmark
          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

          Abstract

          Background

          To evaluate the detectability of arterial acute thrombus on R2* map by iterative decomposition of water and fat with echo asymmetry and least-squares estimation (IDEAL) IQ compared with T2*-weighted imaging (T2*WI).

          Methods

          Twenty-six patients with acute cerebral infarction who underwent R2* map and T2*WI were reviewed. We performed visual assessment of each sequence regarding the visibility of susceptibility effect reflecting acute thrombus and quantitative evaluation of the thrombus on R2* map.

          Results

          Both R2* map and T2*WI showed susceptibility effect reflecting acute thrombi at the occluded site of magnetic resonance angiography (MRA) in 9 patients. R2* map revealed positive while T2*WI showed equivocal findings in 3 patients due to the surrounding vessel signal intensity. Acute thrombus at distal internal carotid artery (ICA) on R2* map was more clearly detected than that on T2*WI without any apparent susceptibility artifact from the skull base in 4 patients. Most of cardiogenic embolic infarction (CEI) and artery-to-artery embolic infarction (A-to-A) demonstrated positive and most of atherothrombotic infarction (ATI) revealed negative findings on R2* map, although quantitative R2* values of thrombi did not show significant differences between CEI (136.6 /msec) and A-to-A (189.9 /msec) ( P = 0.332).

          Conclusion

          The detectability of acute thrombus on R2* map is comparable to that on T2*WI. Regarding thrombus at distal ICA, its detectability on R2* map is superior to that on T2*WI. R2* map provide additional information to distinguish between embolic and atherothrombotic infarctions.

          Related collections

          Most cited references19

          • Record: found
          • Abstract: found
          • Article: not found

          Intracranial thrombus extent predicts clinical outcome, final infarct size and hemorrhagic transformation in ischemic stroke: the clot burden score.

          In ischemic stroke, functional outcomes vary depending on site of intracranial occlusion. We tested the prognostic value of a semiquantitative computed tomography angiography-based clot burden score. Clot burden score allots major anterior circulation arteries 10 points for presence of contrast opacification on computed tomography angiography. Two points each are subtracted for thrombus preventing contrast opacification in the proximal M1, distal M1 or supraclinoid internal carotid artery and one point each for M2 branches, A1 and infraclinoid internal carotid artery. We retrospectively studied patients with disabling neurological deficits (National Institute of Health Stroke Scale score >or=5) and computed tomography angiography within 24-hours from symptom onset. We analyzed percentages independent functional outcome (modified Rankin Scale score
            Bookmark
            • Record: found
            • Abstract: found
            • Article: not found

            Combined R2* and diffusion tensor imaging changes in the substantia nigra in Parkinson's disease.

            Recent magnetic resonance imaging studies suggest an increased transverse relaxation rate and reduced diffusion tensor imaging fractional anisotropy values in the substantia nigra in Parkinson's disease. The transverse relaxation rate and fractional anisotropy changes may reflect different aspects of Parkinson's disease-related pathological processes (ie, tissue iron deposition and microstructure disorganization). This study investigated the combined changes of transverse relaxation rate and fractional anisotropy in the substantia nigra in Parkinson's disease. High-resolution magnetic resonance imaging (T2-weighted, T2*, and diffusion tensor imaging) were obtained from 16 Parkinson's disease patients and 16 controls. Bilateral substantia nigras were delineated manually on T2-weighted images and coregistered to transverse relaxation rate and fractional anisotropy maps. The mean transverse relaxation rate and fractional anisotropy values in each substantia nigra were then calculated and compared between Parkinson's disease subjects and controls. Logistic regression, followed by receiver operating characteristic curve analysis, was employed to investigate the sensitivity and specificity of the combined measures for differentiating Parkinson's disease subjects from controls. Compared with controls, Parkinson's disease subjects demonstrated increased transverse relaxation rate (P<.0001) and reduced fractional anisotropy (P=.0365) in the substantia nigra. There was no significant correlation between transverse relaxation rate and fractional anisotropy values. Logistic regression analyses indicated that the combined use of transverse relaxation rate and fractional anisotropy values provides excellent discrimination between Parkinson's disease subjects and controls (c-statistic=0.996) compared with transverse relaxation rate (c-statistic=0.930) or fractional anisotropy (c-statistic=0.742) alone. This study shows that the combined use of transverse relaxation rate and fractional anisotropy measures in the substantia nigra of Parkinson's disease enhances sensitivity and specificity in differentiating Parkinson's disease from controls. Further studies are warranted to evaluate the pathophysiological correlations of these magnetic resonance imaging measurements and their effectiveness in assisting in diagnosing Parkinson's disease and following its progression. Copyright © 2011 Movement Disorder Society.
              Bookmark
              • Record: found
              • Abstract: found
              • Article: not found

              Clinical and vascular outcome in internal carotid artery versus middle cerebral artery occlusions after intravenous tissue plasminogen activator.

              Early reperfusion is a predictor of good outcome in acute ischemic stroke. We investigated whether middle cerebral artery (MCA) occlusions have a better clinical outcome and proportion of recanalization compared with internal carotid artery (ICA) occlusion after standard treatment with intravenous (IV) tissue plasminogen activator (tPA). In a retrospective analysis of our prospective stroke database between January 7, 1998, and January 30, 2002, we identified 36 consecutive patients who were treated with IV tPA within 3 hours after symptom onset of a stroke in the distribution of a documented ICA or MCA occlusion. The National Institutes of Health Stroke Scale (NIHSS) score was recorded before tPA, at 24 hours, 3 days, and 3 months after stroke. Three-month outcome was recorded by modified Rankin scale. Magnetic resonance angiography or computed tomographic angiography was obtained before tPA. The presence of recanalization was assessed by transcranial Doppler and/or magnetic resonance angiography within 3 days after stroke onset. Nineteen patients had MCA occlusion, and 17 had ICA-plus-MCA occlusion before tPA. Although there was no difference in age and NIHSS at day 0 between the 2 groups, the MCA group had a lower day 3 NIHSS score compared with the ICA group (P=0.006) in an ANCOVA. In addition, patients who had a MCA occlusion had lower day 1 and 3 NIHSS scores compared with the ICA group (P=0.04 and P=0.03, respectively; Wilcoxon rank sum). Similarly, NIHSS was significantly lower in patients who recanalized on days 1 and 3 (P=0.004 and P=0.003 respectively, Wilcoxon rank sum). When we adjusted for NIHSS score at day 0 in an ANCOVA, the adjusted mean was lower in the group that recanalized compared with the group that did not recanalize (P<0.001). There was a significant difference between the proportion of recanalization in the MCA group (15 of 17 recanalized, 88%) at 3 days after tPA compared with that of the ICA group (5 of 16 recanalized, 31%; P=0.001, Fisher exact test). The 3-month modified Rankin scale was not different between the 2 groups. Despite comparable age and NIHSS scores before IV tPA, MCA occlusions have lower day 1 and 3 NIHSS scores and higher proportion of recanalization compared with ICA occlusions. A combined IV/intra-arterial or mechanical thrombolysis may be needed to achieve early recanalization in ICA occlusions.
                Bookmark

                Author and article information

                Journal
                Yonago Acta Med
                Yonago Acta Med
                YAm
                Yonago Acta Medica
                Tottori University Faculty of Medicine
                0513-5710
                1346-8049
                12 September 2016
                September 2016
                : 59
                : 3
                : 204-209
                Affiliations
                [1]*Division of Radiology, Department of Pathophysiological Therapeutic Science, School of Medicine, Tottori University Faculty of Medicine, Yonago 683-8503, Japan
                [2]†Division of Clinical Radiology, Tottori University Hospital, Yonago 683-8504, Japan
                Author notes
                Corresponding author: Yuki Shinohara, MD
                Article
                yam-59-204
                5050269
                27708535
                ffdafd2e-dcaa-46bf-bb0e-590ebb069d46
                2016 Yonago Acta medica
                History
                : 22 June 2016
                : 06 July 2016
                Categories
                Original Article
                Custom metadata
                ATI, atherothrombotic infarction; A-to-A, artery-to-artery embolic infarction; CEI, cardiogenic embolic infarction; DWI, diffusion weighted imaging; FOV, field of view; ICA, internal carotid artery; IDEAL, iterative decomposition of water and fat with echo asymmetry and least-squares estimation; MCA; middle cerebral artery, MR, magnetic resonance; MRA, MR angiography; PCA, posterior cerebral artery; ROI, regions of interest; rtPA, recombinant tissue plasminogen activator; TE, echo time; TR, repetition time; T2*WI, T2*-weighted imaging

                central nervous system,embolism/thrombosis,ischemia/infarction,magnetic resonance imaging

                Comments

                Comment on this article