Neurology
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
QUICK SEARCH:   [advanced]


     

This Article
Right arrow Figures Only
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow CME: Take the course for this article:
 Volume 56, Number 7, April 10, 2001
Right arrow Correspondence:
Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when Correspondence are posted
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Kelly, P.J.
Right arrow Articles by Gonzalez, R.G.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Kelly, P.J.
Right arrow Articles by Gonzalez, R.G.
Neurology 2001;56:914-920
© 2001 American Academy of Neurology
Articles

Diffusion MRI in ischemic stroke compared to pathologically verified infarction

P.J. Kelly, MB, MRCPI;, E.T. Hedley–Whyte, MD;, J. Primavera, MD;, J. He, MD; and R.G. Gonzalez, MD, PhD

From the Departments of Neurology (Dr. Kelly), Neuropathology (Drs. Hedley–Whyte and Primavera), and Neuroradiology (Drs. He and Gonzalez), Massachusetts General Hospital and Harvard Medical School, Boston.

Address correspondence to Dr. Peter J. Kelly, Stroke Service, Department of Neurology, VBK 802, Massachusetts General Hospital, Fruit Street, Boston, MA 02114; e-mail: pjkelly{at}partners.org Address reprint requests to Dr. R.G. Gonzalez, Department of Neuroradiology, GRB 285, Massachusetts General Hospital, Fruit Street, Boston, MA 02114.

BACKGROUND: Diffusion MRI abnormality correlates with pathology in animal ischemic stroke models. A combined retrospective and prospective analysis of consecutive patients over a 3-year period who had a clinical diagnosis of probable new ischemic stroke, underwent diffusion MRI, and were later studied at autopsy was performed.

METHODS: Inclusion criteria for the retrospective analysis were 1) symptom onset within 14 days of presentation, 2) diffusion MRI within 28 days of symptom onset, and 3) autopsy within 16 weeks of symptom onset. Patients with suspected further infarcts between MRI and autopsy were excluded. The locations of all areas of MRI abnormality were identified by a blinded neuroradiologist, and recent infarcts were identified by review of pathologic records and microscopic slides.

RESULTS: Eleven patients were identified who fulfilled inclusion criteria, with 25 discrete pathologic infarcts. Diffusion MRI abnormality corresponded to pathologically verified infarction in 23 cases, was present in two locations where no pathologic infarct was identified, and was absent in two locations where an infarct was present at autopsy. In two cases, despite clinical suspicion of acute ischemic stroke, no MRI abnormality or pathologic infarct was found. The sensitivity and specificity of diffusion MRI were 88.5% (95% CI, 69.9% to 97.6%) and 96.6% (95% CI, 91.5% to 99.1%). Accuracy was 95.1% (95% CI, 90.2% to 98%). Three further patients who died during the course of the retrospective analysis were studied prospectively, and are described separately.

CONCLUSIONS: These findings suggest high accuracy of diffusion MRI for detection of ischemic infarction compared with pathologic examination.






HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
Copyright © 2001 by AAN Enterprises, Inc.