Share：
Share this content in WeChat
X
[Chinese][PDF]99780
• 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.

[1]
Tsivgoulis G, Sharma VK, Mikulik R, et al. Intravenous thrombolysis for acute ischemic stroke occurring during hospitalization for transient ischemic attack. Int J Stroke, 2014, 9(4): 413-418.
[2]
Acampa M, Camarri S, Lazzerini PE, et al. Increased arterial stiffness is an independent risk factor for hemorrhagic transformation in ischemic stroke undergoing thrombolysis. Int J Cardiol, 2017, 243(9): 466-470.
[3]
Stone JA, Willey JZ, Keyrouz S, et al. Therapies for hemorrhagic transformation in acute ischemic stroke. Curr Treat Options Neurol, 2017, 19(1): 1-3.
[4]
Hacke W, Kaste M, Fieschi C, et al. Randomised double-blind placebo-controlled trial of thrombolytic therapy with intravenous alteplase in acute ischaemic stroke (ECASS II). Lancet, 1998, 352(9136): 1245-1251.
[5]
Hoffmann A, Zhu G, Wintermark M. Advanced neuroimaging in stroke patients: prediction of tissue fate and hemorrhagic transformation. Expert Rev Cardiovasc Ther, 2012, 10(4): 515-524.
[6]
中国卒中学会，中国卒中学会神经介入分会，中华预防医学会卒中.急性缺血性卒中血管内治疗中国指南2018.中国卒中杂志, 2018, 13(7): 706-729.
[7]
Jauch EC, Saver JL, Adams HJ, et al. Guidelines for the early management of patients with acute ischemic stroke：a guideline for healthcare professionals from the American Heart Association/American Stroke Association. Stroke, 2013, 44(3): 870-947.
[8]
Strbian D, Mustanoja S, Pekkola J, et al. Intravenous alteplase versus rescue endovascular procedure in patients with proximal middle cerebral artery occlusion. Int J Stroke, 2015, 10(2): 188-193.
[9]
Castro P, Azevedo E, Serrador J, et al. Hemorrhagic transformation and cerebral edema in acute ischemic stroke: link to cerebral autoregulation. J Neurol Sci, 2017, 372(1): 256-261.
[10]
Bouts MJRJ, Tiebosch IACW, Rudrapatna US, et al. Prediction of hemorrhagic transformation after experimental ischemic stroke using MRI-based algorithms. J Cereb Blood Flow Metab, 2017, 37(8): 3065-3076.
[11]
Sehgal V, Delproposto Z, Haacke EM, et al. Clinical applications of neuroimaging with susceptibility-weighted imaging. J Magn Reson Imaging, 2005, 22(4): 439-450.
[12]
Ho BL, Chen CF, Lin RT, et al. Clinical implication of hemorrhagic transformation in ischemic stroke patients treated with recombinant tissue plasminogen activator. Neurol Sci, 2016, 37(11): 1799-1805.
[13]
Scalzo F, Alger JR, Hu X, et al. Multi-center prediction of hemorrhagic transformation in acute ischemic stroke using permeability imaging features. Magn Reson Imaging, 2013, 31(8): 961-969.
[14]
Hermitte L, Cho TH, Ozenne B, et al. Very low cerebral blood volume predicts parenchymal hematoma in acute ischemic stroke. Stroke, 2013, 44(8): 2318-2320.
[15]
Le Bihan D, Breton E, Lallemand D, et al. MR imaging of intravoxel incoherent motions: application to diffusion and perfusion in neurologic disorders. Radiol, 1986, 161(2): 401-407.
[16]
Kim T, Kim SG. Quantification of cerebral arterial blood volume using arterial spin labeling with intravoxel incoherent motion-sensitive gradients. Magn Reson Med, 2006, 55(5): 1047-1057.
[17]
Shinmoto H, Tamura C, Soga S, et al. An intravoxel incoherent motion diffusion-weighted imaging study of prostate cancer. AJR Am J Roentgenol, 2012, 199(4): 496-500.
[18]
Wu WC, Chen YF, Tseng HM, et al. Caveat of measuring perfusion indexes using intravoxel incoherent motion magnetic resonance imaging in the human brain. Eur Radiol, 2015, 25(8): 2485-2492.
[19]
Zu JY, Suo ST, Zhou Z, et al. Comparative study on evaluating brain perfusion of patients with ischemic stroke by intravoxel incoherent motion perfusion imaging and three-dimension arterial spin labeling imaging. J Shanghai Jiaotong Univ(Med Sci), 2015, 35(12): 1038-1042.
[20]
Yao Y, Zhang S, Tang X, et al. Intravoxel incoherent motion diffusion-weighted imaging in stroke patients: initial clinical experience. Clin Radiol, 2016, 71(9): 938-942.
[21]
Federau C, Sumer S, Becce F, et al. Intravoxel incoherent motion perfusion imaging in acute stroke: initial clinical experience. Neuroradiol, 2014, 56(8): 629-635.
[22]
Hu LB, Hong N, Zhu WZ. Quantitative measurement of cerebral perfusion with intravoxel incoherent motion in acute ischemia stroke: initial clinical experience. Chin Med J, 2015, 128(19): 2565.

PREV Evaluating diagnostic value of 3D-SNAP high resolution magnetic resonance in intracranial artery dissection
NEXT Rim enhancement of meningiomas in contrast-enhanced T2 fluid-attenuated inversion recovery magnetic resonance imaging: Based on pathological findings
  


LINK


Tel & Fax: +8610-67113815    E-mail: editor@cjmri.cn