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Comparison of Susceptibility-Weighted Imaging and Perfusion-Weighted Imaging in the Estimation of the Amount of Reversible Ischemic Tissue (Penumbra)

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Abstract

MRI imaging is a method of choice for diagnosis of stroke and able to recognize the area of preventable infarct which selected for reperfusion therapy. Ischemic tissue could be reversed if perfusion is improved as the penumbra. Perfusion-diffusion mismatch was accepted as the standard tool for the evaluation of penumbra. We conducted a recent cross-sectional study to assess the accuracy of SWI-DWI mismatch as noninvasive and available alternative in the detection of penumbra. We determined ischemic tissue via diffusion-weighted images and detection of asymmetric hypointense vein (AHV) on ischemic region in the SWI sequences. After injection of contrast media, perfusion images were performed and finally we determined PWI-DWI and SWI-DWI mismatch values and evaluated the correlation between them. We also determined accuracy of SWI-DWI mismatch and cutoff values of SWI-DWI for detecting optimal PWI-DWI mismatch. Patients with ischemic stroke who were referred to our neuroimaging center and underwent an MRI within 48 h from the onset of symptoms are included in this study. Patients were imaged with stroke protocols including T1, T2 FLAIR, PWI, SWI, and DWI. AHVs were also determined for detection of ischemia in SWI sequences. A total of 30 cases are enrolled and 15 cases were excluded. There was a positive and significant correlation between SWI-DWI and PWI-DWI mismatch ratio (r = 0.34, p = 0.047). The sensitivity, specificity, and accuracy of SWI-DWI for detecting penumbra were 94%, 69%, and 76%. Our results indicated SWI-DWI mismatch is better alternative tool for detection of penumbra and predicting potentially viable brain tissue.

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Data Availability

The data that support the findings of the study are available from the corresponding author in SPSS form upon reasonable request.

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Funding

This study was funded by the Hamadan University of Medical Sciences, Iran.

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Authors and Affiliations

  1. Department of Radiology, School of Medicine, Besat Hospital, Hamadan University of Medical Sciences, Hamadan, Iran

    Meisam Sheikhbabaei & Farideh Gharekhanloo

  2. Department of Neurology, School of Medicine, Sina (Farshchian) Educational and Medical Center, Hamadan University of Medical Sciences, SinaHamadan, Iran

    Farideh Gharekhanloo & Mojtaba Khazaei

  3. Department of Community Medicine, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran

    Azar Pirdehghan

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  1. Meisam Sheikhbabaei
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Contributions

MS, FG and MK developed the original idea and the protocol, abstracted, and prepared the manuscript. FG and AP participated in the study design and analyzed the data. FG and MS contributed to the study design and data gathering. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Farideh Gharekhanloo.

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The study was approved by the Ethics Board of Hamadan University of Medical sciences.

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Sheikhbabaei, M., Gharekhanloo, F., Khazaei, M. et al. Comparison of Susceptibility-Weighted Imaging and Perfusion-Weighted Imaging in the Estimation of the Amount of Reversible Ischemic Tissue (Penumbra). SN Compr. Clin. Med. 5, 36 (2023). https://doi.org/10.1007/s42399-022-01274-2

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