Imageries de diffusion et de perfusion en IRM à la phase hyperaiguë d'un accident vasculaire cérébral ischémique.

Cosnard, Guy;Duprez, Thierry;Grandin, Cécile;Dechambre, S;Smith, A;et.al.
(2000) Journal de radiologie — Vol. 81, n° 8, p. 858-869 (2000)

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  • Cosnard, GuyUCLouvain
    Author
  • Duprez, ThierryUCLouvain
    Author
  • Grandin, CécileUCLouvain
    Author
  • Dechambre, S
    Author
  • Smith, A
    Author
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Abstract
The sensitivity of diffusion-weighted MR imaging to detect a lesion within 6 hours of stroke onset was approximately 90%. The false negative results were usually small lesions (1 ml), were seen early, and were usually located in the brain stem. The specificity of this technique was nearly 100% when it was used correctly. The volume and the value of the apparent diffusion coefficient of the detected lesions provided prognostic information. After injection of a contrast agent (perfusion imaging), a time series of volumes were obtained using a T2* sensitive gradient echo EPI sequence. Hemodynamic perturbations of the cerebral parenchyma could be detected as well as the type of perturbation in the lesion. A map representing the mean transit time for each voxel was used to define the maximum volume of the perturbation. A hemodynamic penumbra was defined to be when this volume was larger than the volume detected on the diffusion images. The quantitative measure of cerebral blood flow could predict the irreversibility of the lesions when the value was below 18 ml/min/100g, and the extension of the ischemia in the penumbra zone when the value was below a threshold of 30 ml/min/100g.
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Cosnard, G., Duprez, T., Grandin, C., Dechambre, S., Mataigne, F., & Smith, A. (2000). Imageries de diffusion et de perfusion en IRM à la phase hyperaiguë d’un accident vasculaire cérébral ischémique. Journal de radiologie, 81(8), 858-869. https://hdl.handle.net/2078.5/85030 (Original work published 2000)