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Zhang Y, Zhuang Y, Ge Y, Wu PY, Zhao J, Wang H, Song B. MRI whole-lesion texture analysis on ADC maps for the prognostic assessment of ischemic stroke. BMC Med Imaging 2022; 22:115. [PMID: 35778678 PMCID: PMC9250246 DOI: 10.1186/s12880-022-00845-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Accepted: 06/23/2022] [Indexed: 11/28/2022] Open
Abstract
Background This study aims is to explore whether it is feasible to use magnetic resonance texture analysis (MRTA) in order to distinguish favorable from unfavorable function outcomes and determine the prognostic factors associated with favorable outcomes of stroke. Methods The retrospective study included 103 consecutive patients who confirmed unilateral anterior circulation subacute ischemic stroke by computed tomography angiography between January 2018 and September 2019. Patients were divided into favorable outcome (modified Rankin scale, mRS ≤ 2) and unfavorable outcome (mRS > 2) groups according to mRS scores at day 90. Two radiologists manually segmented the infarction lesions based on diffusion-weighted imaging and transferred the images to corresponding apparent diffusion coefficient (ADC) maps in order to extract texture features. The prediction models including clinical characteristics and texture features were built using multiple logistic regression. A univariate analysis was conducted to assess the performance of the mean ADC value of the infarction lesion. A Delong’s test was used to compare the predictive performance of models through the receiver operating characteristic curve. Results The mean ADC performance was moderate [AUC = 0.60, 95% confidence interval (CI) 0.49–0.71]. The texture feature model of the ADC map (tADC), contained seven texture features, and presented good prediction performance (AUC = 0.83, 95%CI 0.75–0.91). The energy obtained after wavelet transform, and the kurtosis and skewness obtained after Laplacian of Gaussian transformation were identified as independent prognostic factors for the favorable stroke outcomes. In addition, the combination of the tADC model and clinical characteristics (hypertension, diabetes mellitus, smoking, and atrial fibrillation) exhibited a subtly better performance (AUC = 0.86, 95%CI 0.79–0.93; P > 0.05, Delong’s). Conclusion The models based on MRTA on ADC maps are useful to evaluate the clinical function outcomes in patients with unilateral anterior circulation ischemic stroke. Energy obtained after wavelet transform, kurtosis obtained after Laplacian of Gaussian transform, and skewness obtained after Laplacian of Gaussian transform were identified as independent prognostic factors for favorable stroke outcomes.
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Affiliation(s)
- Yuan Zhang
- Department of Radiology, Minhang Hospital, Fudan University, 170 Xinsong Road, Shanghai, 201199, People's Republic of China
| | - Yuzhong Zhuang
- Department of Radiology, Minhang Hospital, Fudan University, 170 Xinsong Road, Shanghai, 201199, People's Republic of China
| | - Yaqiong Ge
- Department of Medicine, GE Healthcare, Shanghai, People's Republic of China
| | - Pu-Yeh Wu
- Department of Medicine, GE Healthcare, Beijing, People's Republic of China
| | - Jing Zhao
- Department of Neurology, Minhang Hospital, Fudan University, Shanghai, People's Republic of China
| | - Hao Wang
- Department of Radiology, Minhang Hospital, Fudan University, 170 Xinsong Road, Shanghai, 201199, People's Republic of China.
| | - Bin Song
- Department of Radiology, Minhang Hospital, Fudan University, 170 Xinsong Road, Shanghai, 201199, People's Republic of China.
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2
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Duarte-de-Mélo J, Oliveira dos Santos Cajé S, Ribes de Lima L, De Moura Lima IM. Primer reporte de inmaduros de Cryptocephalus Geoffroy, 1762 (Coleoptera: Chrysomelidae) de Brasil con notas de su bioecología sobre Wedelia goyazensis Gardner (Asteraceae) y síntesis de los registros de presencia del género en territorio brasileño. GRAELLSIA 2022. [DOI: 10.3989/graellsia.2022.v78.317] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Cryptocephalus Geoffroy, 1762 es reconocido por su distribución cosmopolita y gran riqueza, con al menos 1700 especies descritas. Sin embargo, falta información para Brasil: (1) no hay registro de inmaduros; y (2) no se conoce casi nada sobre la biología de este género. En este trabajo se documentan por primera vez las etapas inmaduras de Cryptocephalus de Brasil y se presentan algunas notas sobre su bioecología en la planta huésped. Además, se recopilan sus registros en territorio brasileño a partir de la bibliografía.
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Wu WJ, Jiang CJ, Zhang ZY, Xu K, Li W. Diffusion-weighted magnetic resonance imaging reflects activation of signal transducer and activator of transcription 3 during focal cerebral ischemia/reperfusion. Neural Regen Res 2017; 12:1124-1130. [PMID: 28852395 PMCID: PMC5558492 DOI: 10.4103/1673-5374.211192] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
Signal transducer and activator of transcription (STAT) is a unique protein family that binds to DNA, coupled with tyrosine phosphorylation signaling pathways, acting as a transcriptional regulator to mediate a variety of biological effects. Cerebral ischemia and reperfusion can activate STATs signaling pathway, but no studies have confirmed whether STAT activation can be verified by diffusion-weighted magnetic resonance imaging (DWI) in rats after cerebral ischemia/reperfusion. Here, we established a rat model of focal cerebral ischemia injury using the modified Longa method. DWI revealed hyperintensity in parts of the left hemisphere before reperfusion and a low apparent diffusion coefficient. STAT3 protein expression showed no significant change after reperfusion, but phosphorylated STAT3 expression began to increase after 30 minutes of reperfusion and peaked at 24 hours. Pearson correlation analysis showed that STAT3 activation was correlated positively with the relative apparent diffusion coefficient and negatively with the DWI abnormal signal area. These results indicate that DWI is a reliable representation of the infarct area and reflects STAT phosphorylation in rat brain following focal cerebral ischemia/reperfusion.
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Affiliation(s)
- Wen-Juan Wu
- Department of Radiology, Nanjing Medical Unversity Affiliated Wuxi Second People's Hospital, Wuxi, Jiangsu Province, China.,Department of Radiology, Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu Province, China
| | - Chun-Juan Jiang
- Department of Radiology, Nanjing Medical Unversity Affiliated Wuxi Second People's Hospital, Wuxi, Jiangsu Province, China
| | - Zhui-Yang Zhang
- Department of Radiology, Nanjing Medical Unversity Affiliated Wuxi Second People's Hospital, Wuxi, Jiangsu Province, China
| | - Kai Xu
- Department of Radiology, Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu Province, China
| | - Wei Li
- Department of Radiology, Nanjing Medical Unversity Affiliated Wuxi Second People's Hospital, Wuxi, Jiangsu Province, China
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4
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Ali LK, Weng JK, Starkman S, Saver JL, Kim D, Ovbiagele B, Buck BH, Sanossian N, Vespa P, Bang OY, Jahan R, Duckwiler GR, Viñuela F, Liebeskind DS. Heads Up! A Novel Provocative Maneuver to Guide Acute Ischemic Stroke Management. INTERVENTIONAL NEUROLOGY 2016; 6:8-15. [PMID: 28611828 DOI: 10.1159/000449322] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
BACKGROUND A common dilemma in acute ischemic stroke management is whether to pursue recanalization therapy in patients with large vessel occlusions but minimal neurologic deficits. We describe and report preliminary experience with a provocative maneuver, i.e. 90-degree elevation of the head of bed for 30 min, which stresses collaterals and facilitates decision-making. METHODS A prospective cohort study of <7.5 h of acute anterior circulation territory ischemia patients with minimal deficits despite middle cerebral artery (MCA) or internal carotid artery (ICA) occlusive disease. RESULTS Five patients met the study entry criteria. Their mean age was 78.4 years (range 65-93). All presented with substantial deficits (median NIHSS score 11, range 5-22), but improved while in supine position during initial imaging to normal or near-normal (NIHSS score 0-2). MRA showed persistent M1 MCA occlusions in 4, critical ICA stenosis or occlusion in 1, and substantial perfusion-diffusion mismatch in all. To evaluate the potential for eventual collateral failure, patients were placed in a head of bed upright posture. Mean arterial pressure and heart rate were unchanged. Two showed no neurologic worsening and were treated with supportive care with excellent final outcome. Three showed worsening, including recurrent hemiparesis and aphasia at the 6th, recurrent aphasia at the 23rd, and recurrent hemineglect at the 15th upright minute. These 3 underwent endovascular recanalization therapies with successful reperfusion and excellent final outcome. CONCLUSION The 'Heads Up' test may be a useful, simple maneuver to assess the risk of collateral failure and guide the decision to pursue recanalization therapy in acute cerebral ischemia patients with minimal deficits despite persisting large cerebral artery occlusion.
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Affiliation(s)
- Latisha K Ali
- Department of Neurology, David Geffen School of Medicine at UCLA, Los Angeles, Calif., USA
| | - Julius K Weng
- Department of Neurology, David Geffen School of Medicine at UCLA, Los Angeles, Calif., USA.,Department of Emergency Medicine, David Geffen School of Medicine at UCLA, Los Angeles, Calif., USA
| | - Sidney Starkman
- Department of Neurology, David Geffen School of Medicine at UCLA, Los Angeles, Calif., USA.,Department of Emergency Medicine, David Geffen School of Medicine at UCLA, Los Angeles, Calif., USA
| | - Jeffrey L Saver
- Department of Neurology, David Geffen School of Medicine at UCLA, Los Angeles, Calif., USA
| | - Doojin Kim
- Department of Neurology, David Geffen School of Medicine at UCLA, Los Angeles, Calif., USA
| | - Bruce Ovbiagele
- Department of Neurology, Medical University of South Carolina, Charleston, S.C., USA
| | - Brian H Buck
- Department of Neurology, University of Alberta, Edmonton, Alta., Canada, Rio de Janeiro, Brazil
| | - Nerses Sanossian
- Department of Neurology, University of Southern California, Keck School of Medicine, Los Angeles, Calif, USA
| | - Paul Vespa
- Department of Neurology, David Geffen School of Medicine at UCLA, Los Angeles, Calif., USA.,Department of Neurosurgery, UCLA Stroke Center, David Geffen School of Medicine at UCLA, Los Angeles, Calif., USA
| | - Oh Young Bang
- Department of Samsung Medical Center, Sungkyunkwan University, Seoul, South Korea, Rio de Janeiro, Brazil
| | - Reza Jahan
- Department of Neurology, David Geffen School of Medicine at UCLA, Los Angeles, Calif., USA.,Department of Interventional Neuroradiology, UCLA Stroke Center, David Geffen School of Medicine at UCLA, Los Angeles, Calif., USA
| | - Gary R Duckwiler
- Department of Neurology, David Geffen School of Medicine at UCLA, Los Angeles, Calif., USA.,Department of Interventional Neuroradiology, UCLA Stroke Center, David Geffen School of Medicine at UCLA, Los Angeles, Calif., USA
| | | | - David S Liebeskind
- Department of Neurology, David Geffen School of Medicine at UCLA, Los Angeles, Calif., USA
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Schaafs LA, Porter D, Audebert HJ, Fiebach JB, Villringer K. Optimising MR perfusion imaging: comparison of different software-based approaches in acute ischaemic stroke. Eur Radiol 2016; 26:4204-4212. [PMID: 26852218 DOI: 10.1007/s00330-016-4244-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2015] [Revised: 01/05/2016] [Accepted: 01/22/2016] [Indexed: 11/29/2022]
Abstract
OBJECTIVES Perfusion imaging (PI) is susceptible to confounding factors such as motion artefacts as well as delay and dispersion (D/D). We evaluate the influence of different post-processing algorithms on hypoperfusion assessment in PI analysis software packages to improve the clinical accuracy of stroke PI. METHODS Fifty patients with acute ischaemic stroke underwent MRI imaging in the first 24 h after onset. Diverging approaches to motion and D/D correction were applied. The calculated MTT and CBF perfusion maps were assessed by volumetry of lesions and tested for agreement with a standard approach and with the final lesion volume (FLV) on day 6 in patients with persisting vessel occlusion. RESULTS MTT map lesion volumes were significantly smaller throughout the software packages with correction of motion and D/D when compared to the commonly used approach with no correction (p = 0.001-0.022). Volumes on CBF maps did not differ significantly (p = 0.207-0.925). All packages with advanced post-processing algorithms showed a high level of agreement with FLV (ICC = 0.704-0.879). CONCLUSIONS Correction of D/D had a significant influence on estimated lesion volumes and leads to significantly smaller lesion volumes on MTT maps. This may improve patient selection. KEY POINTS • Assessment on hypoperfusion using advanced post-processing with correction for motion and D/D. • CBF appears to be more robust regarding differences in post-processing. • Tissue at risk is estimated more accurately by correcting software algorithms. • Advanced post-processing algorithms show a higher agreement with the final lesion volume.
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Affiliation(s)
- Lars-Arne Schaafs
- Department of Radiology, Charité-Universitätsmedizin, Hindenburgdamm 30, 12203, Berlin, Germany. .,Academic Neuroradiology, Department of Neurology and Center for Stroke Research, Charité-Universitätsmedizin, Berlin, Germany.
| | - David Porter
- Fraunhofer Institute for Medical Image Computing MEVIS, Bremen, Germany
| | - Heinrich J Audebert
- Department of Neurology with Experimental Neurology, Charité-Universitätsmedizin, Berlin, Germany
| | - Jochen B Fiebach
- Academic Neuroradiology, Department of Neurology and Center for Stroke Research, Charité-Universitätsmedizin, Berlin, Germany
| | - Kersten Villringer
- Academic Neuroradiology, Department of Neurology and Center for Stroke Research, Charité-Universitätsmedizin, Berlin, Germany
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6
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Liu D, Sun W, Scalzo F, Xiong Y, Zhang X, Qiu Z, Zhu W, Ma M, Liu W, Xu G, Lu G, Liebeskind DS, Liu X. Early Magnetic Resonance Imaging Predicts Early Neurological Deterioration in Acute Middle Cerebral Artery Minor Stroke. J Stroke Cerebrovasc Dis 2015; 25:469-74. [PMID: 26654665 DOI: 10.1016/j.jstrokecerebrovasdis.2015.10.021] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2015] [Revised: 09/26/2015] [Accepted: 10/23/2015] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Early neurological deterioration (END) is an important factor associated with worse clinical outcome in minor strokes. Early magnetic resonance imaging (MRI) findings can provide better sensitivity to delineate stroke pathophysiology and have diagnostic value associated with causative mechanisms. The aim of this study was to investigate the relationship between early MRI finding and the presence of END in minor stroke patients with lesions in the middle cerebral artery (MCA) territory. METHODS Consecutive MCA minor stroke patients who were admitted to our center within 24 hours of symptom onset were included in this study. All patients underwent MRI within 24 hours of admission. We analyzed baseline characteristics, infarction patterns, and treatment algorithms. The correlation between early MRI findings and END, defined as National Institutes of Health Stroke Scale score increasing more than 2 points during 72 hours after admission, was also determined. RESULTS Across 211 patients meeting entry criteria between January 2010 and December 2013, internal border-zone (IBZ) infarcts on early MRI scan were observed in 23 of 65 patients with END (35.4%) and in 18 of 146 patients without END (12.3%, P < .001). Patients with IBZ infarcts were found to have more hyperlipidemia, less perforating artery infarcts, more pial artery infarcts, more cortical border-zone infarcts and more ipsilateral large arterial stenosis. Logistic regression analysis revealed that IBZ infarct was independently associated with END after adjustment for other factors (odds ratio, 2.50; 95% confidence interval, 1.09-5.74; P = .031). CONCLUSIONS Early MRI patterns of IBZ infarction are associated with END in minor stroke patients with acute infarcts of the MCA territory.
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Affiliation(s)
- Dezhi Liu
- Department of Neurology, Jinling Hospital, Nanjing University School of Medicine, Nanjing, China; Neurovascular Imaging Research Core, Department of Neurology, University of California, Los Angeles, Los Angeles, California
| | - Wen Sun
- Department of Neurology, Jinling Hospital, Nanjing University School of Medicine, Nanjing, China
| | - Fabien Scalzo
- Neurovascular Imaging Research Core, Department of Neurology, University of California, Los Angeles, Los Angeles, California
| | - Yunyun Xiong
- Department of Neurology, Jinling Hospital, Nanjing University School of Medicine, Nanjing, China
| | - Xiaohao Zhang
- Department of Neurology, Jinling Hospital, Nanjing University School of Medicine, Nanjing, China
| | - Zhongming Qiu
- Department of Neurology, Jinling Hospital, Nanjing University School of Medicine, Nanjing, China
| | - Wusheng Zhu
- Department of Neurology, Jinling Hospital, Nanjing University School of Medicine, Nanjing, China
| | - Minmin Ma
- Department of Neurology, Jinling Hospital, Nanjing University School of Medicine, Nanjing, China
| | - Wenhua Liu
- Department of Neurology, Jinling Hospital, Nanjing University School of Medicine, Nanjing, China
| | - Gelin Xu
- Department of Neurology, Jinling Hospital, Nanjing University School of Medicine, Nanjing, China
| | - Guangming Lu
- Department of Radiology, Jinling Hospital, Nanjing University School of Medicine, Nanjing, China
| | - David S Liebeskind
- Neurovascular Imaging Research Core, Department of Neurology, University of California, Los Angeles, Los Angeles, California
| | - Xinfeng Liu
- Department of Neurology, Jinling Hospital, Nanjing University School of Medicine, Nanjing, China.
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