Limits...
Clinical Implications of Sulcal Enhancement on Postcontrast Fluid Attenuated Inversion Recovery Images in Patients with Acute Stroke Symptoms.

Lee H, Kim E, Lee KM, Kim JH, Bae YJ, Choi BS, Jung C - Korean J Radiol (2015)

Bottom Line: Seventy-seven acute stroke patients without any DWI abnormalities were found.The patients with HARM without diffusion abnormalities were significantly older, compared with patients with an imaging-negative stroke (mean, 73.1 years vs. 55.9 years; p < 0.001).Patients with HARM without diffusion abnormalities are older and have similarly favorable short-term neurological outcomes, compared with the patients with imaging-negative stroke.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam 463-707, Korea.

ABSTRACT

Objective: Hyperintense acute reperfusion marker (HARM) without diffusion abnormalities is occasionally found in patients with an acute stroke. This study was to determine the prevalence and clinical implications of HARM without diffusion abnormalities.

Materials and methods: There was a retrospective review of magnetic resonance images 578 patients with acute strokes and identified those who did not have acute infarction lesions, as mapped by diffusion-weighted imaging (DWI). These patients were classified into an imaging-negative stroke and HARM without diffusion abnormalities groups, based on the DWI findings and postcontrast fluid attenuated inversion recovery images. The National Institutes of Health Stroke Scale (NIHSS) scores at admission, 1 day, and 7 days after the event, as well as clinical data and risk factors, were compared between the imaging-negative stroke and HARM without diffusion abnormalities groups.

Results: Seventy-seven acute stroke patients without any DWI abnormalities were found. There were 63 patients with an imaging-negative stroke (accounting for 10.9% of 578) and 13 patients with HARM without diffusion abnormalities (accounting for 2.4% of 578). The NIHSS scores at admission were higher in HARM without diffusion abnormalities group than in the imaging-negative stroke group (median, 4.5 vs. 1.0; p < 0.001), but the scores at 7 days after the event were not significantly different between the two groups (median, 0 vs. 0; p = 1). The patients with HARM without diffusion abnormalities were significantly older, compared with patients with an imaging-negative stroke (mean, 73.1 years vs. 55.9 years; p < 0.001).

Conclusion: Patients with HARM without diffusion abnormalities are older and have similarly favorable short-term neurological outcomes, compared with the patients with imaging-negative stroke.

No MeSH data available.


Related in: MedlinePlus

Flow chart shows patients' selection process in this study.CE-FLAIR = contrast-enhanced FLAIR images, DWI = diffusion-weighted imaging, FLAIR = fluid attenuated inversion recovery, HARM = hyperintense acute reperfusion marker on contrast-enhanced FLAIR, ICH = intracerebral hemorrhage, SAH = subarachnoid hemorrhage, SDH = subdural hemorrhage
© Copyright Policy - open-access
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC4499557&req=5

Figure 1: Flow chart shows patients' selection process in this study.CE-FLAIR = contrast-enhanced FLAIR images, DWI = diffusion-weighted imaging, FLAIR = fluid attenuated inversion recovery, HARM = hyperintense acute reperfusion marker on contrast-enhanced FLAIR, ICH = intracerebral hemorrhage, SAH = subarachnoid hemorrhage, SDH = subdural hemorrhage

Mentions: Among the 578 patients with acute stroke or TIA, 501 patients (86.7%) had acute infarction lesions on the diffusion-weighted images (DWIs). Of the 77 patients without acute infarction lesions on the DWIs, the presence of early HARM signs on FLAIR images motivated the researchers to divide the patients into two groups, namely the imaging-negative stroke group and the HARM without diffusion abnormalities group. In detail, an imaging-negative stroke was defined as the absence of acute infarction on the DWIs and early HARM signs on postcontrast FLAIR images, while HARM without diffusion abnormalities was defined as the absence of acute infarction on DWIs with the presence of early HARM signs on postcontrast FLAIR images. Figure 1 shows a flow chart of the selection process for patients in this study.


Clinical Implications of Sulcal Enhancement on Postcontrast Fluid Attenuated Inversion Recovery Images in Patients with Acute Stroke Symptoms.

Lee H, Kim E, Lee KM, Kim JH, Bae YJ, Choi BS, Jung C - Korean J Radiol (2015)

Flow chart shows patients' selection process in this study.CE-FLAIR = contrast-enhanced FLAIR images, DWI = diffusion-weighted imaging, FLAIR = fluid attenuated inversion recovery, HARM = hyperintense acute reperfusion marker on contrast-enhanced FLAIR, ICH = intracerebral hemorrhage, SAH = subarachnoid hemorrhage, SDH = subdural hemorrhage
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4499557&req=5

Figure 1: Flow chart shows patients' selection process in this study.CE-FLAIR = contrast-enhanced FLAIR images, DWI = diffusion-weighted imaging, FLAIR = fluid attenuated inversion recovery, HARM = hyperintense acute reperfusion marker on contrast-enhanced FLAIR, ICH = intracerebral hemorrhage, SAH = subarachnoid hemorrhage, SDH = subdural hemorrhage
Mentions: Among the 578 patients with acute stroke or TIA, 501 patients (86.7%) had acute infarction lesions on the diffusion-weighted images (DWIs). Of the 77 patients without acute infarction lesions on the DWIs, the presence of early HARM signs on FLAIR images motivated the researchers to divide the patients into two groups, namely the imaging-negative stroke group and the HARM without diffusion abnormalities group. In detail, an imaging-negative stroke was defined as the absence of acute infarction on the DWIs and early HARM signs on postcontrast FLAIR images, while HARM without diffusion abnormalities was defined as the absence of acute infarction on DWIs with the presence of early HARM signs on postcontrast FLAIR images. Figure 1 shows a flow chart of the selection process for patients in this study.

Bottom Line: Seventy-seven acute stroke patients without any DWI abnormalities were found.The patients with HARM without diffusion abnormalities were significantly older, compared with patients with an imaging-negative stroke (mean, 73.1 years vs. 55.9 years; p < 0.001).Patients with HARM without diffusion abnormalities are older and have similarly favorable short-term neurological outcomes, compared with the patients with imaging-negative stroke.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam 463-707, Korea.

ABSTRACT

Objective: Hyperintense acute reperfusion marker (HARM) without diffusion abnormalities is occasionally found in patients with an acute stroke. This study was to determine the prevalence and clinical implications of HARM without diffusion abnormalities.

Materials and methods: There was a retrospective review of magnetic resonance images 578 patients with acute strokes and identified those who did not have acute infarction lesions, as mapped by diffusion-weighted imaging (DWI). These patients were classified into an imaging-negative stroke and HARM without diffusion abnormalities groups, based on the DWI findings and postcontrast fluid attenuated inversion recovery images. The National Institutes of Health Stroke Scale (NIHSS) scores at admission, 1 day, and 7 days after the event, as well as clinical data and risk factors, were compared between the imaging-negative stroke and HARM without diffusion abnormalities groups.

Results: Seventy-seven acute stroke patients without any DWI abnormalities were found. There were 63 patients with an imaging-negative stroke (accounting for 10.9% of 578) and 13 patients with HARM without diffusion abnormalities (accounting for 2.4% of 578). The NIHSS scores at admission were higher in HARM without diffusion abnormalities group than in the imaging-negative stroke group (median, 4.5 vs. 1.0; p < 0.001), but the scores at 7 days after the event were not significantly different between the two groups (median, 0 vs. 0; p = 1). The patients with HARM without diffusion abnormalities were significantly older, compared with patients with an imaging-negative stroke (mean, 73.1 years vs. 55.9 years; p < 0.001).

Conclusion: Patients with HARM without diffusion abnormalities are older and have similarly favorable short-term neurological outcomes, compared with the patients with imaging-negative stroke.

No MeSH data available.


Related in: MedlinePlus