Evaluation of infarct core and ischemic penumbra by absolute quantitative cerebral dynamic susceptibility contrast perfusion magnetic resonance imaging using self-calibrated echo planar imaging sequencing in patients with acute ischemic stroke

Quantitative Imaging in Medicine and Surgery

article

Xiaoyue Ma¹  Yan Wang²  Mengke Wang²  Menghuan Zhang²  Nan Meng²  Long Zhang³  Jinlong Zhang³  Shewei Dou²  Meiyun Wang² 

[1] Department of Magnetic Resonance Imaging , the First Affiliated Hospital of Zhengzhou University;Department of Radiology , Zhengzhou University People’s Hospital;Department of Neurology , Zhengzhou University People’s Hospital

关键词: Ischemic stroke (IS);    magnetic resonance;    quantification;    dynamic susceptibility contrast (DSC);    Self-CALibrated Epi Perfusion-Weighted Imaging (SCALE-PWI);   

DOI  :  10.21037/qims-21-975

学科分类：外科医学

来源: AME Publications

【 摘 要 】

Background: It has been hypothesized that an absolute quantitative dynamic susceptibility contrast (DSC) cerebral perfusion-weighted imaging (PWI) technique based on self-calibrated echo-planar imaging (EPI) could be a reliable measurement of quantitative cerebral blood flow (qCBF) and quantitative cerebral blood volume (qCBV). This study aimed to investigate the clinical value of this technique in offering a unique insight into ischemic stroke (IS) pathophysiology and improving the sensitivity of IS diagnosis. Methods: A total of 14 patients with IS who underwent routine magnetic resonance imaging (MRI) and Self-CALibrated EPI Perfusion-Weighted Imaging (SCALE-PWI) scanning were prospectively recruited as a consecutive convenience sample. qCBF and qCBV maps were processed immediately online after the scan. Then, 2 radiologists independently drew the region of interest (ROI) of the infarct core, ischemic penumbra, and the contralateral normal tissues on each map for the statistical analyses. The paired-samples t-test, Wilcoxon signed-rank test, independent-samples t-test, and receiver operating characteristic (ROC) curve were performed. A value of P<0.05 was considered statistically significant with 95% confidence intervals (CI). Results: All the values of qCBF and qCBV in the lesions were lower than those in the contralateral normal tissues (all P<0.05). The values of qCBF and qCBV in the infarct core were lower than those in the ischemic penumbra (mean values: 16.42 vs. 21.54 mL/100 g/min, P=0.013; 1.23 vs. 1.47 mL/100 g, P=0.049, respectively). The qCBF threshold of the infarct core was 18.18 mL/100 g/min (sensitivity, 71.40%; specificity, 64.30%) and the qCBF threshold of the ischemic penumbra was 28.09 mL/100 g/min (sensitivity, 78.60%; specificity, 85.70%). Conclusions: Different from the previous semi-quantitative measurement, the SCALE-PWI technique has the potential to provide absolute quantitative hemodynamic information which may be used to detect the infarct core and ischemic penumbra in a relatively short scan time.

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