Fully Automated and Real-Time Volumetric Measurement of Infarct Core and Penumbra in Diffusion- and Perfusion-Weighted MRI of Patients with Hyper-Acute Stroke

被引:21
作者
Lee, Hyunna [1 ]
Jung, Kyesam [2 ]
Kang, Dong-Wha [3 ]
Kim, Namkug [4 ,5 ]
机构
[1] Asan Med Ctr, Asan Inst Life Sci, Hlth Innovat Big Data Ctr, Seoul 05505, South Korea
[2] Res Ctr Julich, Inst Neurosci & Med Brain & Behav INM 7, D-52425 Julich, Germany
[3] Univ Ulsan, Coll Med, Dept Neurol, Asan Med Ctr, Seoul 05505, South Korea
[4] Univ Ulsan, Coll Med, Asan Med Ctr, Dept Convergence Med, Seoul 05505, South Korea
[5] Univ Ulsan, Coll Med, Asan Med Ctr, Dept Radiol, Seoul 05505, South Korea
关键词
Stroke; Penumbra; Infarct; PWI; DWI; Segmentation; ISCHEMIC PENUMBRA; LESION SEGMENTATION; THROMBOLYSIS; THROMBECTOMY; THERAPY; INJURY;
D O I
10.1007/s10278-019-00222-2
中图分类号
R8 [特种医学]; R445 [影像诊断学];
学科分类号
1002 ; 100207 ; 1009 ;
摘要
Multimodal magnetic resonance imaging (MRI) has emerged as a promising tool for diagnosing ischemic stroke and for determining treatment strategies in the acute phase. The detection and quantification of the penumbra and the infarct core regions aid the assessment of the potential risks and benefits of thrombolysis by providing information on salvageable tissue or ischemic lesion age. In this study, we proposed a fully automated and real-time algorithm to compute parameter maps of perfusion-weighted images (PWIs) and to identify an infarct core from diffusion-weighted images (DWIs). DWI and PWI were obtained using a 1.5 Tesla MRI scanner for 15 patients with acute ischemic stroke. Parameter maps of PWI were computed using restricted gamma-variate curve fitting and Fourier-based deconvolution. The ischemic penumbra was identified using time-to-maximum (T-max) > 6 s as the mutual optimal threshold, while the infarct core was segmented using an adaptive thresholding on DWI. When the penumbra on PWI was compared with that generated using commercial software Pearson's linear correlation coefficient between penumbra volumes was 0.601 (p = 0.030), and the Dice coefficient was 0.51 +/- 0.15. The infarct core on DWI was compared with the manually segmented gold standard. Dice coefficient between the manually drawn and automated segmented infarct cores was 0.62 +/- 0.18. The processing times for PWI and DWI were 222.9 +/- 16.4 and 53.4 +/- 4.8 s, respectively. In conclusion, we demonstrate a fully automated and real-time algorithm to segment the penumbra and the infarct core regions based on PWI and DWI.
引用
收藏
页码:262 / 272
页数:11
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