AustralieFrV1, Main, Exploration, bibRecord, 005278

Quantitative measurements of relative fluid-attenuated inversion recovery (FLAIR) signal intensities in acute stroke for the prediction of time from symptom onset

Identifieur interne : 005278 ( Main/Exploration ); précédent : 005277; suivant : 005279

Quantitative measurements of relative fluid-attenuated inversion recovery (FLAIR) signal intensities in acute stroke for the prediction of time from symptom onset

Auteurs : Bastian Cheng [Allemagne] ; Mathias Brinkmann [Allemagne] ; Nils D. Forkert [Allemagne] ; Andras Treszl [Allemagne] ; Martin Ebinger [Allemagne] ; Martin Köhrmann [Allemagne] ; Ona Wu [États-Unis] ; Dong-Wha Kang [Corée du Sud] ; David S. Liebeskind [États-Unis] ; Thomas Tourdias [France] ; Oliver C. Singer [Allemagne] ; Soren Christensen [Australie] ; Marie Luby [États-Unis] ; Steven Warach [États-Unis] ; Jens Fiehler [Allemagne] ; Jochen B. Fiebach [Allemagne] ; Christian Gerloff [Allemagne] ; Götz Thomalla [Allemagne]

Source :

Journal of Cerebral Blood Flow & Metabolism [ 0271-678X ] ; 2012.

RBID : PMC:3965287

Abstract

In acute stroke magnetic resonance imaging, a ‘mismatch' between visibility of an ischemic lesion on diffusion-weighted imaging (DWI) and missing corresponding parenchymal hyperintensities on fluid-attenuated inversion recovery (FLAIR) data sets was shown to identify patients with time from symptom onset ≤4.5 hours with high specificity. However, moderate sensitivity and suboptimal interpreter agreement are limitations of a visual rating of FLAIR lesion visibility. We tested refined image analysis methods in patients included in the previously published PREFLAIR study using refined visual analysis and quantitative measurements of relative FLAIR signal intensity (rSI) from a three-dimensional, segmented stroke lesion volume. A total of 399 patients were included. The rSI of FLAIR lesions showed a moderate correlation with time from symptom onset (r=0.382, P<0.001). A FLAIR rSI threshold of <1.0721 predicted symptom onset ≤4.5 hours with slightly increased specificity (0.85 versus 0.78) but also slightly decreased sensitivity (0.47 versus 0.58) as compared with visual analysis. Refined visual analysis differentiating between ‘subtle' and ‘obvious' FLAIR hyperintensities and classification and regression tree algorithms combining information from visual and quantitative analysis also did not improve diagnostic accuracy. Our results raise doubts whether the prediction of stroke onset time by visual image judgment can be improved by quantitative rSI measurements.

Url:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3965287

DOI: 10.1038/jcbfm.2012.129
PubMed: 23047272
PubMed Central: 3965287

Affiliations:

Allemagne, Australie, Corée du Sud, France, États-Unis

Le document en format XML

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<sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Quantitative measurements of relative fluid-attenuated inversion recovery (FLAIR)
signal intensities in acute stroke for the prediction of time from symptom onset</title>
<author><name sortKey="Cheng, Bastian" sort="Cheng, Bastian" uniqKey="Cheng B" first="Bastian" last="Cheng">Bastian Cheng</name>
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<country xml:lang="fr">Allemagne</country>
<wicri:regionArea># see nlm:aff country strict</wicri:regionArea>
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<country xml:lang="fr">Allemagne</country>
<wicri:regionArea># see nlm:aff country strict</wicri:regionArea>
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<author><name sortKey="Wu, Ona" sort="Wu, Ona" uniqKey="Wu O" first="Ona" last="Wu">Ona Wu</name>
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, Boston, Massachusetts,<country>USA</country>
</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea># see nlm:aff country strict</wicri:regionArea>
</affiliation>
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<author><name sortKey="Kang, Dong Wha" sort="Kang, Dong Wha" uniqKey="Kang D" first="Dong-Wha" last="Kang">Dong-Wha Kang</name>
<affiliation wicri:level="1"><nlm:aff id="aff7"><institution>Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine</institution>
, Seoul,<country>South Korea</country>
</nlm:aff>
<country xml:lang="fr">Corée du Sud</country>
<wicri:regionArea># see nlm:aff country strict</wicri:regionArea>
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<author><name sortKey="Liebeskind, David S" sort="Liebeskind, David S" uniqKey="Liebeskind D" first="David S" last="Liebeskind">David S. Liebeskind</name>
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<country xml:lang="fr">États-Unis</country>
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<author><name sortKey="Tourdias, Thomas" sort="Tourdias, Thomas" uniqKey="Tourdias T" first="Thomas" last="Tourdias">Thomas Tourdias</name>
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, Bordeaux,<country>France</country>
</nlm:aff>
<country xml:lang="fr">France</country>
<wicri:regionArea># see nlm:aff country strict</wicri:regionArea>
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<author><name sortKey="Singer, Oliver C" sort="Singer, Oliver C" uniqKey="Singer O" first="Oliver C" last="Singer">Oliver C. Singer</name>
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, Erlangen,<country>Germany</country>
</nlm:aff>
<country xml:lang="fr">Allemagne</country>
<wicri:regionArea># see nlm:aff country strict</wicri:regionArea>
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<author><name sortKey="Christensen, Soren" sort="Christensen, Soren" uniqKey="Christensen S" first="Soren" last="Christensen">Soren Christensen</name>
<affiliation wicri:level="1"><nlm:aff id="aff11"><institution>Department of Neurology, Royal Melbourne Hospital, University of Melbourne</institution>
, Parkville, Victoria,<country>Australia</country>
</nlm:aff>
<country xml:lang="fr">Australie</country>
<wicri:regionArea># see nlm:aff country strict</wicri:regionArea>
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<author><name sortKey="Luby, Marie" sort="Luby, Marie" uniqKey="Luby M" first="Marie" last="Luby">Marie Luby</name>
<affiliation wicri:level="1"><nlm:aff id="aff12"><institution>National Institute of Neurological Disorders and Stroke</institution>
, Bethesda, Maryland,<country>USA</country>
</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea># see nlm:aff country strict</wicri:regionArea>
</affiliation>
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<author><name sortKey="Warach, Steven" sort="Warach, Steven" uniqKey="Warach S" first="Steven" last="Warach">Steven Warach</name>
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, Bethesda, Maryland,<country>USA</country>
</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea># see nlm:aff country strict</wicri:regionArea>
</affiliation>
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<author><name sortKey="Fiehler, Jens" sort="Fiehler, Jens" uniqKey="Fiehler J" first="Jens" last="Fiehler">Jens Fiehler</name>
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, Hamburg,<country>Germany</country>
</nlm:aff>
<country xml:lang="fr">Allemagne</country>
<wicri:regionArea># see nlm:aff country strict</wicri:regionArea>
</affiliation>
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<author><name sortKey="Fiebach, Jochen B" sort="Fiebach, Jochen B" uniqKey="Fiebach J" first="Jochen B" last="Fiebach">Jochen B. Fiebach</name>
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, Berlin,<country>Germany</country>
</nlm:aff>
<country xml:lang="fr">Allemagne</country>
<wicri:regionArea># see nlm:aff country strict</wicri:regionArea>
</affiliation>
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<author><name sortKey="Gerloff, Christian" sort="Gerloff, Christian" uniqKey="Gerloff C" first="Christian" last="Gerloff">Christian Gerloff</name>
<affiliation wicri:level="1"><nlm:aff id="aff1"><institution>Klinik und Poliklinik für Neurologie, Kopf- und Neurozentrum, Universitätsklinikum Hamburg-Eppendorf</institution>
, Hamburg,<country>Germany</country>
</nlm:aff>
<country xml:lang="fr">Allemagne</country>
<wicri:regionArea># see nlm:aff country strict</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Thomalla, Gotz" sort="Thomalla, Gotz" uniqKey="Thomalla G" first="Götz" last="Thomalla">Götz Thomalla</name>
<affiliation wicri:level="1"><nlm:aff id="aff1"><institution>Klinik und Poliklinik für Neurologie, Kopf- und Neurozentrum, Universitätsklinikum Hamburg-Eppendorf</institution>
, Hamburg,<country>Germany</country>
</nlm:aff>
<country xml:lang="fr">Allemagne</country>
<wicri:regionArea># see nlm:aff country strict</wicri:regionArea>
</affiliation>
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<series><title level="j">Journal of Cerebral Blood Flow & Metabolism</title>
<idno type="ISSN">0271-678X</idno>
<idno type="eISSN">1559-7016</idno>
<imprint><date when="2012">2012</date>
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<front><div type="abstract" xml:lang="en"><p>In acute stroke magnetic resonance imaging, a ‘mismatch' between visibility
of an ischemic lesion on diffusion-weighted imaging (DWI) and missing corresponding
parenchymal hyperintensities on fluid-attenuated inversion recovery (FLAIR) data sets was
shown to identify patients with time from symptom onset ≤4.5 hours with high
specificity. However, moderate sensitivity and suboptimal interpreter agreement are
limitations of a visual rating of FLAIR lesion visibility. We tested refined image
analysis methods in patients included in the previously published PREFLAIR study using
refined visual analysis and quantitative measurements of relative FLAIR signal intensity
(rSI) from a three-dimensional, segmented stroke lesion volume. A total of 399 patients
were included. The rSI of FLAIR lesions showed a moderate correlation with time from
symptom onset (<italic>r</italic>
=0.382, <italic>P</italic><0.001). A FLAIR rSI threshold of
<1.0721 predicted symptom onset ≤4.5 hours with slightly increased
specificity (0.85 versus 0.78) but also slightly decreased sensitivity (0.47 versus 0.58)
as compared with visual analysis. Refined visual analysis differentiating between
‘subtle' and ‘obvious' FLAIR hyperintensities and classification
and regression tree algorithms combining information from visual and quantitative analysis
also did not improve diagnostic accuracy. Our results raise doubts whether the prediction
of stroke onset time by visual image judgment can be improved by quantitative rSI
measurements.</p>
</div>
</front>
</TEI>
<affiliations><list><country><li>Allemagne</li>
<li>Australie</li>
<li>Corée du Sud</li>
<li>France</li>
<li>États-Unis</li>
</country>
</list>
<tree><country name="Allemagne"><noRegion><name sortKey="Cheng, Bastian" sort="Cheng, Bastian" uniqKey="Cheng B" first="Bastian" last="Cheng">Bastian Cheng</name>
</noRegion>
<name sortKey="Brinkmann, Mathias" sort="Brinkmann, Mathias" uniqKey="Brinkmann M" first="Mathias" last="Brinkmann">Mathias Brinkmann</name>
<name sortKey="Ebinger, Martin" sort="Ebinger, Martin" uniqKey="Ebinger M" first="Martin" last="Ebinger">Martin Ebinger</name>
<name sortKey="Fiebach, Jochen B" sort="Fiebach, Jochen B" uniqKey="Fiebach J" first="Jochen B" last="Fiebach">Jochen B. Fiebach</name>
<name sortKey="Fiehler, Jens" sort="Fiehler, Jens" uniqKey="Fiehler J" first="Jens" last="Fiehler">Jens Fiehler</name>
<name sortKey="Forkert, Nils D" sort="Forkert, Nils D" uniqKey="Forkert N" first="Nils D" last="Forkert">Nils D. Forkert</name>
<name sortKey="Gerloff, Christian" sort="Gerloff, Christian" uniqKey="Gerloff C" first="Christian" last="Gerloff">Christian Gerloff</name>
<name sortKey="Kohrmann, Martin" sort="Kohrmann, Martin" uniqKey="Kohrmann M" first="Martin" last="Köhrmann">Martin Köhrmann</name>
<name sortKey="Singer, Oliver C" sort="Singer, Oliver C" uniqKey="Singer O" first="Oliver C" last="Singer">Oliver C. Singer</name>
<name sortKey="Thomalla, Gotz" sort="Thomalla, Gotz" uniqKey="Thomalla G" first="Götz" last="Thomalla">Götz Thomalla</name>
<name sortKey="Treszl, Andras" sort="Treszl, Andras" uniqKey="Treszl A" first="Andras" last="Treszl">Andras Treszl</name>
</country>
<country name="États-Unis"><noRegion><name sortKey="Wu, Ona" sort="Wu, Ona" uniqKey="Wu O" first="Ona" last="Wu">Ona Wu</name>
</noRegion>
<name sortKey="Liebeskind, David S" sort="Liebeskind, David S" uniqKey="Liebeskind D" first="David S" last="Liebeskind">David S. Liebeskind</name>
<name sortKey="Luby, Marie" sort="Luby, Marie" uniqKey="Luby M" first="Marie" last="Luby">Marie Luby</name>
<name sortKey="Warach, Steven" sort="Warach, Steven" uniqKey="Warach S" first="Steven" last="Warach">Steven Warach</name>
</country>
<country name="Corée du Sud"><noRegion><name sortKey="Kang, Dong Wha" sort="Kang, Dong Wha" uniqKey="Kang D" first="Dong-Wha" last="Kang">Dong-Wha Kang</name>
</noRegion>
</country>
<country name="France"><noRegion><name sortKey="Tourdias, Thomas" sort="Tourdias, Thomas" uniqKey="Tourdias T" first="Thomas" last="Tourdias">Thomas Tourdias</name>
</noRegion>
</country>
<country name="Australie"><noRegion><name sortKey="Christensen, Soren" sort="Christensen, Soren" uniqKey="Christensen S" first="Soren" last="Christensen">Soren Christensen</name>
</noRegion>
</country>
</tree>
</affiliations>
</record>

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Quantitative measurements of relative fluid-attenuated inversion recovery (FLAIR) signal intensities in acute stroke for the prediction of time from symptom onset

Quantitative measurements of relative fluid-attenuated inversion recovery (FLAIR) signal intensities in acute stroke for the prediction of time from symptom onset

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