Associations Between Diffusion Dynamics and Functional Outcome in Acute and Early Subacute Ischemic Stroke
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ORIGINAL ARTICLE
Associations Between Diffusion Dynamics and Functional Outcome in Acute and Early Subacute Ischemic Stroke Chengxia Liu1 · Shun Zhang1 · Yihao Yao1 · Changliang Su1 · Zhenxiong Wang1 · Minghuan Wang2 · Wenzhen Zhu1 Received: 24 September 2018 / Accepted: 29 June 2019 © Springer-Verlag GmbH Germany, part of Springer Nature 2019
Abstract Purpose The current study aimed to investigate the associations between diffusion dynamics of ischemic lesions and clinical functional outcome of acute and early subacute stroke. Material and Methods A total of 80 patients with first ever infarcts in the territory of the middle cerebral artery underwent multi-b-values diffusion-weighted imaging and diffusion kurtosis imaging. Multiple diffusion parameters were generated in postprocessing using different diffusion models. Long-term functional outcome was evaluated with modified Rankin scale (mRS) at 6 months post-stroke. Good functional outcome was defined as mRS score Ä 2 and poor functional outcome was defined as mRS score ≥ 3. Univariate analysis was used to compare the diffusion parameters and clinical features between patients with poor and good functional outcome. Significant parameters were further analyzed for correlations with functional outcome using partial correlation. Results In univariate analyses, standard-b-values apparent diffusion coefficient (ADCst) ratio and fractional anisotropy (FA) ratio of acute stroke, ADCst ratio and mean kurtosis (MK) ratio of early subacute stroke were statistically different between patients with poor outcome and good outcome (P < 0.05). When the potential confounding factor of lesion volume was controlled, only FA ratio of acute stroke, ADCst ratio and MK ratio of early subacute stroke remained correlated with the functional outcome (P < 0.05). Conclusion Diffusion dynamics are correlated with the clinical functional outcome of ischemic stroke. This correlation is independent of the effect of lesion volume and is specific to the time period between symptom onset and imaging. More effort is needed to further investigate the predictive value of diffusion-weighted imaging.
Keywords Diffusion weighted imaging · Apparent diffusion coefficient · Stroke · Functional outcome · Mean kurtosis
Introduction
This study has been orally presented in the 102nd Scientific Assembly and Annual Meeting of the Radiological Society of North America in Chicago on 29 November 2016. Electronic supplementary material The online version of this article (https://doi.org/10.1007/s00062-019-00812-1) contains supplementary material, which is available to authorized users. Wenzhen Zhu
[email protected] 1
Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jiefang Avenue, 430030 Wuhan, China
2
Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 430030 Wuhan, China
The predictive value of clinical measurements such as age, baseline neurological status, baseline lev
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