Intravoxel incoherent motion imaging in stroke infarct core and penumbra is related to long-term clinical outcome
Abstract Intravoxel incoherent motion (IVIM) imaging, a contrast agent-free magnetic resonance imaging technique, enables the evaluation of microvascular perfusion abnormalities in acute stroke. Prior research reported reduced IVIM values within the infarct core in acute stroke. However, findings co...
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Nature Portfolio
2024-11-01
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| Series: | Scientific Reports |
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| Online Access: | https://doi.org/10.1038/s41598-024-81280-7 |
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| author | Josua Zimmermann Beno Reolon Lars Michels Bence Nemeth Dunja Gorup Massimo Barbagallo Jacopo Bellomo Bas van Niftrik Martina Sebök Vittorio Stumpo Susanne Wegener Jorn Fierstra Zsolt Kulcsar Christoph Stippich Andreas R. Luft Marco Piccirelli Tilman Schubert |
| author_facet | Josua Zimmermann Beno Reolon Lars Michels Bence Nemeth Dunja Gorup Massimo Barbagallo Jacopo Bellomo Bas van Niftrik Martina Sebök Vittorio Stumpo Susanne Wegener Jorn Fierstra Zsolt Kulcsar Christoph Stippich Andreas R. Luft Marco Piccirelli Tilman Schubert |
| author_sort | Josua Zimmermann |
| collection | DOAJ |
| description | Abstract Intravoxel incoherent motion (IVIM) imaging, a contrast agent-free magnetic resonance imaging technique, enables the evaluation of microvascular perfusion abnormalities in acute stroke. Prior research reported reduced IVIM values within the infarct core in acute stroke. However, findings concerning IVIM characteristics in the penumbra have been mixed and the relationship between IVIM and clinical outcomes remains unknown. We employed a longitudinal multimodal imaging approach for ischemic stroke patients (n analyzed=24; pre-/post-treatment and 90-day post-stroke assessments) including IVIM, diffusion-weighted, and contrast-enhanced perfusion-weighted imaging. We evaluated IVIM in relevant stroke areas after endovascular treatment. Reduced post-treatment IVIM perfusion fraction in infarct core and recanalized penumbra was associated with poorer functional recovery at 90-days post-stroke (NIH Stroke Scale [NIHSS]; r=-0.64 and r=-0.69). Including IVIM perfusion fraction increased the explained variance of NIHSS from 42% up to 83% compared to well-known prognostic factors core volume and patient age. Additionally, IVIM perfusion fraction was reduced in the core and recanalized penumbra compared to contralateral healthy tissue, suggesting impaired microvascular reperfusion after endovascular treatment. In conclusion, IVIM characteristics of the infarct core and recanalized penumbra are strong prognostic factors for long-term outcome in stroke patients and IVIM shows promise for characterizing microvascular perfusion in relevant stroke areas. |
| format | Article |
| id | doaj-art-94b4d80e900c4b3e90419a12c1aa99e6 |
| institution | Kabale University |
| issn | 2045-2322 |
| language | English |
| publishDate | 2024-11-01 |
| publisher | Nature Portfolio |
| record_format | Article |
| series | Scientific Reports |
| spelling | doaj-art-94b4d80e900c4b3e90419a12c1aa99e62024-12-01T12:21:45ZengNature PortfolioScientific Reports2045-23222024-11-0114111010.1038/s41598-024-81280-7Intravoxel incoherent motion imaging in stroke infarct core and penumbra is related to long-term clinical outcomeJosua Zimmermann0Beno Reolon1Lars Michels2Bence Nemeth3Dunja Gorup4Massimo Barbagallo5Jacopo Bellomo6Bas van Niftrik7Martina Sebök8Vittorio Stumpo9Susanne Wegener10Jorn Fierstra11Zsolt Kulcsar12Christoph Stippich13Andreas R. Luft14Marco Piccirelli15Tilman Schubert16Department of Neurology, University Hospital ZurichDepartment of Neuroradiology, University Hospital ZurichDepartment of Neuroradiology, University Hospital ZurichDepartment of Neuroradiology, University Hospital ZurichDepartment of Neuroradiology, University Hospital ZurichDepartment of Neurology, University Hospital ZurichDepartment of Neurosurgery, University Hospital ZurichDepartment of Neurosurgery, University Hospital ZurichDepartment of Neurosurgery, University Hospital ZurichDepartment of Neurosurgery, University Hospital ZurichDepartment of Neurology, University Hospital ZurichNeuroscience Center Zurich, University of Zurich and ETH ZurichDepartment of Neuroradiology, University Hospital ZurichSchmieder Clinic AllensbachDepartment of Neurology, University Hospital ZurichDepartment of Neuroradiology, University Hospital ZurichDepartment of Neuroradiology, University Hospital ZurichAbstract Intravoxel incoherent motion (IVIM) imaging, a contrast agent-free magnetic resonance imaging technique, enables the evaluation of microvascular perfusion abnormalities in acute stroke. Prior research reported reduced IVIM values within the infarct core in acute stroke. However, findings concerning IVIM characteristics in the penumbra have been mixed and the relationship between IVIM and clinical outcomes remains unknown. We employed a longitudinal multimodal imaging approach for ischemic stroke patients (n analyzed=24; pre-/post-treatment and 90-day post-stroke assessments) including IVIM, diffusion-weighted, and contrast-enhanced perfusion-weighted imaging. We evaluated IVIM in relevant stroke areas after endovascular treatment. Reduced post-treatment IVIM perfusion fraction in infarct core and recanalized penumbra was associated with poorer functional recovery at 90-days post-stroke (NIH Stroke Scale [NIHSS]; r=-0.64 and r=-0.69). Including IVIM perfusion fraction increased the explained variance of NIHSS from 42% up to 83% compared to well-known prognostic factors core volume and patient age. Additionally, IVIM perfusion fraction was reduced in the core and recanalized penumbra compared to contralateral healthy tissue, suggesting impaired microvascular reperfusion after endovascular treatment. In conclusion, IVIM characteristics of the infarct core and recanalized penumbra are strong prognostic factors for long-term outcome in stroke patients and IVIM shows promise for characterizing microvascular perfusion in relevant stroke areas.https://doi.org/10.1038/s41598-024-81280-7Intravoxel incoherent motion imagingAcute stroke imagingMagnetic resonance imagingStrokeLong-term clinical outcomeMicrovascular perfusion |
| spellingShingle | Josua Zimmermann Beno Reolon Lars Michels Bence Nemeth Dunja Gorup Massimo Barbagallo Jacopo Bellomo Bas van Niftrik Martina Sebök Vittorio Stumpo Susanne Wegener Jorn Fierstra Zsolt Kulcsar Christoph Stippich Andreas R. Luft Marco Piccirelli Tilman Schubert Intravoxel incoherent motion imaging in stroke infarct core and penumbra is related to long-term clinical outcome Scientific Reports Intravoxel incoherent motion imaging Acute stroke imaging Magnetic resonance imaging Stroke Long-term clinical outcome Microvascular perfusion |
| title | Intravoxel incoherent motion imaging in stroke infarct core and penumbra is related to long-term clinical outcome |
| title_full | Intravoxel incoherent motion imaging in stroke infarct core and penumbra is related to long-term clinical outcome |
| title_fullStr | Intravoxel incoherent motion imaging in stroke infarct core and penumbra is related to long-term clinical outcome |
| title_full_unstemmed | Intravoxel incoherent motion imaging in stroke infarct core and penumbra is related to long-term clinical outcome |
| title_short | Intravoxel incoherent motion imaging in stroke infarct core and penumbra is related to long-term clinical outcome |
| title_sort | intravoxel incoherent motion imaging in stroke infarct core and penumbra is related to long term clinical outcome |
| topic | Intravoxel incoherent motion imaging Acute stroke imaging Magnetic resonance imaging Stroke Long-term clinical outcome Microvascular perfusion |
| url | https://doi.org/10.1038/s41598-024-81280-7 |
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