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• Clinical Article •
Prediction of hemorrhagic transformation after revascularization in patients with acute ischemic stroke based on IVIM
ZHANG Huawen  ZHOU Xin  LIU Tonghui  LI Peng  ZHOU Lin 

Cite this article as: Zhang HW, Zhou X, Liu TH, et al. Prediction of hemorrhagic transformation after revascularization in patients with acute ischemic stroke based on IVIM. Chin J Magn Reson Imaging, 2019, 10(2): 110-114. DOI:10.12015/issn.1674-8034.2019.02.007.


[Abstract] Objective: To explore the significance of introvoxel incoherent motion (IVIM) imaging in predicting the hemorrhagic transformation (HT) of acute ischemic stroke (AIS) after revascularization and provide theoretical basis for individualized therapy.Materials and Methods: 60 patients with AIS confirmed by clinical or imaging examination were studied and all the patients were scanned with multi-b diffusion-weighted imaging (muti-b DWI) before revascularization. We used IVIM imaging technique to measure the three coefficients inclouding diffusion coefficient of pure diffusion (D), pseudo-diffusion coefficient (D*) and perfusion fraction (f) in infarct value and mirror region and then we calculated the relative values of each parameter (rD, rD*, rf). Further, we performed susceptibility weighted imaging (SWI) within 3 days after treatment, to observe the hemorrhagic transformation and analyze the relationship between IVIM parameters and HT after treatment in patients with AIS.Results: The D, D*, f values of the infarct area on the affected side of AIS patients before revascularization were lower than those of the contralateral mirror area, even there was a significant difference between the two sides (t=12.934, 12.234, 24.069, P<0.01). the rD, rD*, rf values of the infarct area in the HT group before treatment were lower than those in the non-HT group, and there was a significant difference between the two groups (t=2.982, 3.090, 4.656, P<0.01). After taking the optimal threshold of rD 0.527, rD* 0.519 and rf 0.495, the sensitivity and the specificity were 76.9%, 73.7%; 84.6%, 78.9%; 84.6%, 89.5% respectively.Conclusions: IVIM parameters of infarct area before treatment can predict a risk of HT in patients with AIS after revascularization, even having the highest value of rf.
[Keywords] stroke；hemorrhagic transformation；revascularization；intravoxel incoherent motion；mechanical thrombolysis；susceptibility weighted imaging；magnetic resonance imaging

ZHANG Huawen* Department of Radiology, Nuclear Industry 215 Hospital of Shaanxi province, Xianyang 712000, China

ZHOU Xin Department of Radiology, Nuclear Industry 215 Hospital of Shaanxi province, Xianyang 712000, China

LIU Tonghui Department of Radiology, Nuclear Industry 215 Hospital of Shaanxi province, Xianyang 712000, China

LI Peng Department of Radiology, Nuclear Industry 215 Hospital of Shaanxi province, Xianyang 712000, China

ZHOU Lin Department of Radiology, Nuclear Industry 215 Hospital of Shaanxi province, Xianyang 712000, China

*Correspondence to: Zhang HW, E-mail: 1579226281@qq.com

Conflicts of interest   None.

ACKNOWLEDGMENTS  This work was part of Shaanxi Science and Technology Research Project No.2016FS-199
Received  2018-08-21
Accepted  2018-10-18
DOI: 10.12015/issn.1674-8034.2019.02.007
Cite this article as: Zhang HW, Zhou X, Liu TH, et al. Prediction of hemorrhagic transformation after revascularization in patients with acute ischemic stroke based on IVIM. Chin J Magn Reson Imaging, 2019, 10(2): 110-114. DOI:10.12015/issn.1674-8034.2019.02.007.

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