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  • Title: Use of T1 relaxation time in rotating frame (T1 ρ) and apparent diffusion coefficient to estimate cerebral stroke evolution.
    Author: Tan Y, Xu J, Chen R, Chen B, Xu J, Ren D, Chan Q, Mei Y, Wu Y, Xu Y.
    Journal: J Magn Reson Imaging; 2018 Nov; 48(5):1247-1254. PubMed ID: 29446510.
    Abstract:
    BACKGROUND: The major factor for the appropriate treatment strategies for ischemia patients is its onset timing. PURPOSE/HYPOTHESIS: To study to evaluate the diagnostic accuracy of T1 relaxation time in a rotating frame (T1 ρ) and apparent diffusion coefficient (ADC) from MRI to estimate ischemia stages. STUDY TYPE: Prospective. POPULATION/SUBJECTS/PHANTOM/SPECIMEN/ANIMAL MODEL: In all, 73 patients (49 males, aged 29-78 years and 24 females, aged 22-94 years) with ischemia were prospectively imaged with T1 ρ and diffusion MRI during the postischemic period. FIELD STRENGTH/SEQUENCE: 3T/T1 ρ and diffusion-weighted imaging (DWI). ASSESSMENT: Ischemic parenchyma included tissue with elevated signal areas on DWI and correlative hypointense areas on ADC maps. STATISTICAL TESTS: The sensitivity of variables to ischemia time was quantified by analyzing the respective correlations of these values with onset time. RESULTS: ΔT1 ρ (ipsilateral-contralateral differences in T1 ρ) (R2  = 0.956) and T1 ρipsi (ipsilateral ischemia T1 ρ values) (R2  = 0.941) were elevated in all ischemic lesions; these values increased linearly as a function of time, unlike ΔADC (ipsilateral-contralateral differences in ADC) (R2  = -0.410) and ADCipsi (ipsilateral ischemia ADC values) (R2  = 0.550). ΔT1 ρ and T1 ρipsi were significantly different between all stages (P < 0.01), except the acute and hyperacute stages (P = 0.589 for ΔT1 ρ, P = 0.290 for T1 ρipsi , respectively), but ΔADC and ADCipsi only between the late subacute and early subacute stages (P < 0.01) and the late subacute and chronic stages (P < 0.01). DATA CONCLUSION: These data suggest that T1 ρ can provide estimates for the ischemic time in patients. T1 ρ has the potential to outperform diffusion for single-timepoint examination because the T1 ρ change during strokes is positive and linear. If patients with suspected stroke are scanned by MRI within the appropriate timeframe, T1 ρ may provide tools for evaluating stroke onset, potentially aiding in treatment strategies. LEVEL OF EVIDENCE: 4 Technical Efficacy: Stage 3 J. Magn. Reson. Imaging 2018;47:1247-1254.
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