Acute stroke syndromes with isolated hypoperfusion on MRI: a clinical and MRI study
Background: Acute stroke syndromes with negative diffusion-weighted imaging (DWI) but extensive perfusion deficits are rare and constitute a diagnostic challenge due to different operational definitions of penumbral hypoperfusion in acute stroke patients based on MRI criteria. Methods: MR profiles o...
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| Main Authors: | , , , , , , |
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| Format: | Article (Journal) |
| Language: | English |
| Published: |
January 7, 2016
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| In: |
European neurology
Year: 2016, Volume: 75, Issue: 1-2, Pages: 27-32 |
| ISSN: | 1421-9913 |
| DOI: | 10.1159/000443305 |
| Online Access: | Verlag, Volltext: http://dx.doi.org/10.1159/000443305 Verlag, Volltext: https://www-karger-com.ezproxy.medma.uni-heidelberg.de/Article/FullText/443305 
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| Author Notes: | Angelika Alonso, Kristina Szabo, Marc E. Wolf, Anne D. Ebert, Martin Griebe, Michael G. Hennerici, Achim Gass |
| Summary: | Background: Acute stroke syndromes with negative diffusion-weighted imaging (DWI) but extensive perfusion deficits are rare and constitute a diagnostic challenge due to different operational definitions of penumbral hypoperfusion in acute stroke patients based on MRI criteria. Methods: MR profiles of 19 patients presenting with acute stroke syndromes with negative DWI in the presence of an extensive area of hypoperfusion on time-to-peak (TTP) maps of dynamic susceptibility contrast perfusion-weighted imaging (PWI) were analysed. DWI and PWI lesions were quantified and interpreted with regard to the clinical course. Results: Despite the large area of abnormal perfusion on TTP maps, the clinical course was benign (median National Institute of Health Stroke Scale 2 at admission, 0 at discharge). The volume of hypoperfused tissue was significantly smaller on postprocessed TTP maps with a TTP delay of >4 s than on unprocessed TTP maps with manual contrast adjustment. Semiquantitatively assessed TTP lesion volume was associated with the presence of DWI lesions on follow-up. Conclusion: TTP maps are highly sensitive to demonstrate even small-scale perfusion abnormalities. The additional information from TTP delay thresholds indicates critically reduced perfusion and appears to be a good prognostic indicator in combination with MR angiography and symptomatology. |
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| Item Description: | Gesehen am 09.01.2019 |
| Physical Description: | Online Resource |
| ISSN: | 1421-9913 |
| DOI: | 10.1159/000443305 |