Infarct volume on apparent diffusion coefficient maps correlates with length of stay and outcome after middle cerebral artery stroke

Stefan T. Engelter, James M. Provenzale, Jeffrey R. Petrella, David M. DeLong, Mark J. Alberts

Research output: Contribution to journalArticle

56 Citations (Scopus)

Abstract

Background: Diffusion-weighted MRI (DWI) can depict acute ischemia based on decreased apparent diffusion coefficient (ADC) values. ADC maps, unlike DWI (which have contributions from T2 properties), solely reflect diffusion properties. Recent studies indicate that severity of neurological deficit corresponds with degree of ADC alteration. Purpose: To determine whether infarct volume on ADC maps correlates with length of hospitalization and clinical outcome in patients with acute ischemic middle cerebral artery (MCA) stroke. Study Population: Forty-five consecutive patients with acute (≤72 h) MCA infarcts seen on DWI. Methods: Infarct volume was determined by counting pixels with ADC values >3 SDs below the average ADC value of a contralateral control region. Infarct volume was correlated with length of hospitalization and 6-month outcome assessed with Glasgow Outcome Scale (GOS), Modified Rankin Score (mRS), Barthel Index (BI) and a dichotomized outcome status with favorable outcome defined as GOS 1, mRS ≤1 and BI ≥95. Results: Infarct volume on ADC maps ranged from 0.2 to 187 cm3 and was significantly correlated with length of hospitalization (p<0.001, r = 0.67). Furthermore, ADC infarct volume was significantly correlated with GOS (r = 0.73), mRS (r = 0.68), BI (r = 0.67) and outcome status (r = 0.65) (each p<0.001). Multiple logistic regression revealed a statistically significant correlation between ADC infarct volume and outcome status (p<0.05), but none for Canadian Neurological Scale score, age and gender (p>0.05 each). Conclusion: Infarct volume measured by using a quantitative definition for infarcted tissue on ADC maps correlated significantly with length of hospitalization (as a possible surrogate marker for short-term outcome) and functional outcome after 6 months. ADC infarct volume may provide prognostic information for patients with acute ischemic MCA stroke.

Original languageEnglish (US)
Pages (from-to)188-191
Number of pages4
JournalCerebrovascular Diseases
Volume15
Issue number3
DOIs
StatePublished - 2003

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Middle Cerebral Artery Infarction
Length of Stay
Diffusion Magnetic Resonance Imaging
Hospitalization
Glasgow Outcome Scale
Middle Cerebral Artery
Ischemia
Biomarkers

Keywords

  • Apparent diffusion coefficient
  • Diffusion MR imaging
  • Length of stay
  • Middle cerebral artery stroke
  • Outcome

ASJC Scopus subject areas

  • Clinical Neurology

Cite this

Infarct volume on apparent diffusion coefficient maps correlates with length of stay and outcome after middle cerebral artery stroke. / Engelter, Stefan T.; Provenzale, James M.; Petrella, Jeffrey R.; DeLong, David M.; Alberts, Mark J.

In: Cerebrovascular Diseases, Vol. 15, No. 3, 2003, p. 188-191.

Research output: Contribution to journalArticle

Engelter, Stefan T. ; Provenzale, James M. ; Petrella, Jeffrey R. ; DeLong, David M. ; Alberts, Mark J. / Infarct volume on apparent diffusion coefficient maps correlates with length of stay and outcome after middle cerebral artery stroke. In: Cerebrovascular Diseases. 2003 ; Vol. 15, No. 3. pp. 188-191.
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abstract = "Background: Diffusion-weighted MRI (DWI) can depict acute ischemia based on decreased apparent diffusion coefficient (ADC) values. ADC maps, unlike DWI (which have contributions from T2 properties), solely reflect diffusion properties. Recent studies indicate that severity of neurological deficit corresponds with degree of ADC alteration. Purpose: To determine whether infarct volume on ADC maps correlates with length of hospitalization and clinical outcome in patients with acute ischemic middle cerebral artery (MCA) stroke. Study Population: Forty-five consecutive patients with acute (≤72 h) MCA infarcts seen on DWI. Methods: Infarct volume was determined by counting pixels with ADC values >3 SDs below the average ADC value of a contralateral control region. Infarct volume was correlated with length of hospitalization and 6-month outcome assessed with Glasgow Outcome Scale (GOS), Modified Rankin Score (mRS), Barthel Index (BI) and a dichotomized outcome status with favorable outcome defined as GOS 1, mRS ≤1 and BI ≥95. Results: Infarct volume on ADC maps ranged from 0.2 to 187 cm3 and was significantly correlated with length of hospitalization (p<0.001, r = 0.67). Furthermore, ADC infarct volume was significantly correlated with GOS (r = 0.73), mRS (r = 0.68), BI (r = 0.67) and outcome status (r = 0.65) (each p<0.001). Multiple logistic regression revealed a statistically significant correlation between ADC infarct volume and outcome status (p<0.05), but none for Canadian Neurological Scale score, age and gender (p>0.05 each). Conclusion: Infarct volume measured by using a quantitative definition for infarcted tissue on ADC maps correlated significantly with length of hospitalization (as a possible surrogate marker for short-term outcome) and functional outcome after 6 months. ADC infarct volume may provide prognostic information for patients with acute ischemic MCA stroke.",
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T1 - Infarct volume on apparent diffusion coefficient maps correlates with length of stay and outcome after middle cerebral artery stroke

AU - Engelter, Stefan T.

AU - Provenzale, James M.

AU - Petrella, Jeffrey R.

AU - DeLong, David M.

AU - Alberts, Mark J.

PY - 2003

Y1 - 2003

N2 - Background: Diffusion-weighted MRI (DWI) can depict acute ischemia based on decreased apparent diffusion coefficient (ADC) values. ADC maps, unlike DWI (which have contributions from T2 properties), solely reflect diffusion properties. Recent studies indicate that severity of neurological deficit corresponds with degree of ADC alteration. Purpose: To determine whether infarct volume on ADC maps correlates with length of hospitalization and clinical outcome in patients with acute ischemic middle cerebral artery (MCA) stroke. Study Population: Forty-five consecutive patients with acute (≤72 h) MCA infarcts seen on DWI. Methods: Infarct volume was determined by counting pixels with ADC values >3 SDs below the average ADC value of a contralateral control region. Infarct volume was correlated with length of hospitalization and 6-month outcome assessed with Glasgow Outcome Scale (GOS), Modified Rankin Score (mRS), Barthel Index (BI) and a dichotomized outcome status with favorable outcome defined as GOS 1, mRS ≤1 and BI ≥95. Results: Infarct volume on ADC maps ranged from 0.2 to 187 cm3 and was significantly correlated with length of hospitalization (p<0.001, r = 0.67). Furthermore, ADC infarct volume was significantly correlated with GOS (r = 0.73), mRS (r = 0.68), BI (r = 0.67) and outcome status (r = 0.65) (each p<0.001). Multiple logistic regression revealed a statistically significant correlation between ADC infarct volume and outcome status (p<0.05), but none for Canadian Neurological Scale score, age and gender (p>0.05 each). Conclusion: Infarct volume measured by using a quantitative definition for infarcted tissue on ADC maps correlated significantly with length of hospitalization (as a possible surrogate marker for short-term outcome) and functional outcome after 6 months. ADC infarct volume may provide prognostic information for patients with acute ischemic MCA stroke.

AB - Background: Diffusion-weighted MRI (DWI) can depict acute ischemia based on decreased apparent diffusion coefficient (ADC) values. ADC maps, unlike DWI (which have contributions from T2 properties), solely reflect diffusion properties. Recent studies indicate that severity of neurological deficit corresponds with degree of ADC alteration. Purpose: To determine whether infarct volume on ADC maps correlates with length of hospitalization and clinical outcome in patients with acute ischemic middle cerebral artery (MCA) stroke. Study Population: Forty-five consecutive patients with acute (≤72 h) MCA infarcts seen on DWI. Methods: Infarct volume was determined by counting pixels with ADC values >3 SDs below the average ADC value of a contralateral control region. Infarct volume was correlated with length of hospitalization and 6-month outcome assessed with Glasgow Outcome Scale (GOS), Modified Rankin Score (mRS), Barthel Index (BI) and a dichotomized outcome status with favorable outcome defined as GOS 1, mRS ≤1 and BI ≥95. Results: Infarct volume on ADC maps ranged from 0.2 to 187 cm3 and was significantly correlated with length of hospitalization (p<0.001, r = 0.67). Furthermore, ADC infarct volume was significantly correlated with GOS (r = 0.73), mRS (r = 0.68), BI (r = 0.67) and outcome status (r = 0.65) (each p<0.001). Multiple logistic regression revealed a statistically significant correlation between ADC infarct volume and outcome status (p<0.05), but none for Canadian Neurological Scale score, age and gender (p>0.05 each). Conclusion: Infarct volume measured by using a quantitative definition for infarcted tissue on ADC maps correlated significantly with length of hospitalization (as a possible surrogate marker for short-term outcome) and functional outcome after 6 months. ADC infarct volume may provide prognostic information for patients with acute ischemic MCA stroke.

KW - Apparent diffusion coefficient

KW - Diffusion MR imaging

KW - Length of stay

KW - Middle cerebral artery stroke

KW - Outcome

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