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  • Title: Comparison of susceptibility-weighted and perfusion-weighted magnetic resonance imaging in the detection of penumbra in acute ischemic stroke.
    Author: Luo S, Yang L, Wang L.
    Journal: J Neuroradiol; 2015 Oct; 42(5):255-60. PubMed ID: 25451668.
    Abstract:
    BACKGROUND AND PURPOSE: To investigate detection of ischemic penumbra in stroke patients with acute cerebral infarction by susceptibility-weighted imaging (SWI) in comparison with perfusion-weighted imaging (PWI). MATERIALS AND METHODS: This study included 18 stroke patients with acute infarction who underwent diffusion-weighted imaging (DWI), SWI, PWI, and magnetic resonance angiography (MRA) within 3 days after symptom onset. The Alberta Stroke Program Early CT Score (ASPECTS) was used to evaluate lesions on DWI, SWI, and PWI. DWI-SWI and DWI-PWI mismatches were calculated. RESULTS: The DWI-SWI mismatch was not significantly different from the DWI-mean transit time (MTT) mismatch (P=0.163) in evaluating ischemic penumbra. The susceptibility vessel sign (SVS) in SWI occurred in 11 (61%) of 18 patients with cerebral infarction. Stenosis or occlusion of the affected vessels was identified by MRA in 10 (91%) of the 11 SVS-positive patients. The SVS on SWI was significantly associated with the occurrence of damaged vessels or the presence of thrombus in the affected vessels (P=0.047). CONCLUSIONS: DWI-SWI mismatch is a good marker for evaluating ischemic penumbra in stroke patients with cerebral infarction. SWI can detect thrombus in the affected vessels, and may be useful for guiding intra-arterial thrombolytic therapy.
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