Significance of arterial spin labeling perfusion and susceptibility weighted imaging changes in patients with transient ischemic attack: a prospective cohort study
Abstract 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 suba...
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| Language: | English |
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BMC
2018-08-01
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| Series: | BMC Medical Imaging |
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| Online Access: | http://link.springer.com/article/10.1186/s12880-018-0264-6 |
| _version_ | 1818836096883097600 |
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| author | Inger Havsteen Lasse Willer Christian Ovesen Janus Damm Nybing Karen Ægidius Jacob Marstrand Per Meden Sverre Rosenbaum Marie Norsker Folke Hanne Christensen Anders Christensen |
| author_facet | Inger Havsteen Lasse Willer Christian Ovesen Janus Damm Nybing Karen Ægidius Jacob Marstrand Per Meden Sverre Rosenbaum Marie Norsker Folke Hanne Christensen Anders Christensen |
| author_sort | Inger Havsteen |
| collection | DOAJ |
| description | Abstract 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. |
| first_indexed | 2024-12-19T03:01:11Z |
| format | Article |
| id | doaj.art-3bd4c687525640ddb862f22ada167fcd |
| institution | Directory Open Access Journal |
| issn | 1471-2342 |
| language | English |
| last_indexed | 2024-12-19T03:01:11Z |
| publishDate | 2018-08-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Medical Imaging |
| spelling | doaj.art-3bd4c687525640ddb862f22ada167fcd2022-12-21T20:38:11ZengBMCBMC Medical Imaging1471-23422018-08-011811810.1186/s12880-018-0264-6Significance of arterial spin labeling perfusion and susceptibility weighted imaging changes in patients with transient ischemic attack: a prospective cohort studyInger Havsteen0Lasse Willer1Christian Ovesen2Janus Damm Nybing3Karen Ægidius4Jacob Marstrand5Per Meden6Sverre Rosenbaum7Marie Norsker Folke8Hanne Christensen9Anders Christensen10Department of Radiology, Copenhagen University Hospital BispebjergDepartment of Neurology, Copenhagen University Hospital BispebjergDepartment of Neurology, Copenhagen University Hospital BispebjergDepartment of Radiology, Copenhagen University Hospital BispebjergDepartment of Neurology, Copenhagen University Hospital BispebjergDepartment of Neurology, Copenhagen University Hospital BispebjergDepartment of Neurology, Copenhagen University Hospital BispebjergDepartment of Neurology, Copenhagen University Hospital BispebjergDepartment of Neurology, Copenhagen University Hospital BispebjergDepartment of Neurology, Copenhagen University Hospital BispebjergDepartment of Radiology, Copenhagen University Hospital BispebjergAbstract 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.http://link.springer.com/article/10.1186/s12880-018-0264-6Transient ischemic attackCerebral cortexArterial spin labeling |
| spellingShingle | Inger Havsteen Lasse Willer Christian Ovesen Janus Damm Nybing Karen Ægidius Jacob Marstrand Per Meden Sverre Rosenbaum Marie Norsker Folke Hanne Christensen Anders Christensen Significance of arterial spin labeling perfusion and susceptibility weighted imaging changes in patients with transient ischemic attack: a prospective cohort study BMC Medical Imaging Transient ischemic attack Cerebral cortex Arterial spin labeling |
| title | Significance of arterial spin labeling perfusion and susceptibility weighted imaging changes in patients with transient ischemic attack: a prospective cohort study |
| title_full | Significance of arterial spin labeling perfusion and susceptibility weighted imaging changes in patients with transient ischemic attack: a prospective cohort study |
| title_fullStr | Significance of arterial spin labeling perfusion and susceptibility weighted imaging changes in patients with transient ischemic attack: a prospective cohort study |
| title_full_unstemmed | Significance of arterial spin labeling perfusion and susceptibility weighted imaging changes in patients with transient ischemic attack: a prospective cohort study |
| title_short | Significance of arterial spin labeling perfusion and susceptibility weighted imaging changes in patients with transient ischemic attack: a prospective cohort study |
| title_sort | significance of arterial spin labeling perfusion and susceptibility weighted imaging changes in patients with transient ischemic attack a prospective cohort study |
| topic | Transient ischemic attack Cerebral cortex Arterial spin labeling |
| url | http://link.springer.com/article/10.1186/s12880-018-0264-6 |
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