Magnetic resonance imaging in acute ischemic stroke treatment
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TLDR
Understanding the clinical implication of various useful MRI findings and comprehensively incorporating those variables into therapeutic decision-making may be a more reasonable approach for expanding the indication of acute stroke thrombolysis.Abstract:
Although intravenous administration of tissue plasminogen activator is the only proven treatment after acute ischemic stroke, there is always a concern of hemorrhagic risk after thrombolysis. Therefore, selection of patients with potential benefits in overcoming potential harms of thrombolysis is of great importance. Despite the practical issues in using magnetic resonance imaging (MRI) for acute stroke treatment, multimodal MRI can provide useful information for accurate diagnosis of stroke, evaluation of the risks and benefits of thrombolysis, and prediction of outcomes. For example, the high sensitivity and specificity of diffusion-weighted image (DWI) can help distinguish acute ischemic stroke from stroke-mimics. Additionally, the lesion mismatch between perfusion-weighted image (PWI) and DWI is thought to represent potential salvageable tissue by reperfusion therapy. However, the optimal threshold to discriminate between benign oligemic areas and the penumbra is still debatable. Signal changes of fluid-attenuated inversion recovery image within DWI lesions may be a surrogate marker for ischemic lesion age and might indicate risks of hemorrhage after thrombolysis. Clot sign on gradient echo image may reflect the nature of clot, and their location, length and morphology may provide predictive information on recanalization by reperfusion therapy. However, previous clinical trials which solely or mainly relied on perfusion-diffusion mismatch for patient selection, failed to show benefits of MRI-based thrombolysis. Therefore, understanding the clinical implication of various useful MRI findings and comprehensively incorporating those variables into therapeutic decision-making may be a more reasonable approach for expanding the indication of acute stroke thrombolysis.read more
Citations
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Deep into the Brain: Artificial Intelligence in Stroke Imaging.
TL;DR: A glimpse at the use of AI in stroke imaging is offered, specifically focusing on its technical principles, clinical application, and future perspectives.
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Machine Learning Approach to Identify Stroke Within 4.5 Hours.
Hyunna Lee,Eun-Jae Lee,Sungwon Ham,Han-Bin Lee,Ji Sung Lee,Sun U. Kwon,Jong S. Kim,Namkug Kim,Dong-Wha Kang +8 more
TL;DR: Machine learning techniques analyzing diffusion-weighted imaging and fluid-attenuated inversion recovery magnetic resonance imaging to identify patients within the recommended time window for thrombolysis were investigated.
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Sang-Beom Jeon,Chang Hwan Sohn,Dong Woo Seo,Bum Jin Oh,Kyoung Soo Lim,Dong-Wha Kang,Won Young Kim +6 more
TL;DR: The presence of acute brain lesions was significantly associated with the development of delayed neurological sequelae and diffusion-weighted imaging during the acute phase of carbon monoxide poisoning may help identify patients at risk of developing these debilitating sequelae.
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Romain Bourcier,M. Mazighi,Julien Labreuche,Robert Fahed,Raphaël Blanc,Benjamin Gory,Alain Duhamel,Gaultier Marnat,Suzana Saleme,Vincent Costalat,Serge Bracard,Hubert Desal,Arturo Consoli,Michel Piotin,Bertrand Lapergue +14 more
TL;DR: As a first line strategy, SR achieved higher recanalization rates and a more favourable clinical outcome at 3 months compared to CA when MRI shows SVS within the thrombus.
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Ischemic Diffusion Lesion Reversal After Endovascular Treatment
Joonsang Yoo,Jin Wook Choi,Seong-Joon Lee,Jiman Hong,Jeong-Ho Hong,Chang-Hyun Kim,Yong-Won Kim,Dong-Hun Kang,Yong-Sun Kim,Yang-Ha Hwang,Bruce Ovbiagele,Andrew M. Demchuk,Jin Soo Lee,Sung Il Sohn +13 more
TL;DR: Complete reperfusion and shorter imaging time to recanalization were independently associated with DWI reversal among patients with acute ischemic stroke who received EVT.
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Journal Article
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