Use of multi-modal non-contrast MRI to predict functional outcomes after stroke: A study using DP-pCASL, DTI, NODDI, and MAP MRI

IF 3.4 2区医学 Q2 NEUROIMAGING

Neuroimage-Clinical Pub Date : 2025-01-01 DOI:10.1016/j.nicl.2025.103742

Julia Diamandi , Christian Raimondo , Keenan Piper , Joanna Roy , Stephanie Serva , Mahdi Alizadeh , Adam Flanders , Stavropoula Tjoumakaris , Reid Gooch , Pascal Jabbour , Robert Rosenwasser , Nikolaos Mouchtouris

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引用次数: 0

Abstract

Purpose

This study aims to assess whether water exchange rate (k_w), a surrogate for blood–brain barrier (BBB) permeability, is associated with functional outcomes in patients with acute ischemic stroke (AIS).

Methods

We studied 22 AIS patients enrolled from 1/2022 to 4/2024 who underwent multi-modal non-contrast imaging on a 3.0-Tesla scanner, including DP-pCASL, DTI, NODDI and MAP imaging. For each parametric map, the intensity and standard deviation (SD) were calculated for the infarcted region. The diffusion maps included were b0, Fractional Anisotropy (FA), Mean Diffusivity (MD), Intra-cellular Volume Fraction (ICVF), Free Water Fraction (FWF), and Orientation Dispersion Index (ODI), q-Space Mean Square Displacement (QMSD), Return-to-Axis Probability (RTAP), Return-to-Plane Probability (RTPP), Return-to-Origin Probability (RTOP), Propagator Anisotropy (PA), and non-Gaussianity (NG). The perfusion-based maps were cerebral blood flow (CBF), arterial transit time (ATT), and k_w. The outcome variable was modified Rankin Scale (mRS).

Results

Twenty-two patients were included. The average age was 69.5 ± 13.5, the mean NIHSS of 12.4 ± 7.7, and the median infarct of 25.7 (8.4–98.8) ml. Multivariable linear regression identified lower k_w (β = −0.029, p = 0.041), longer time to MRI (β = 0.012, p = 0.013) and larger stroke volume (β = 0.014, p = 0.006) as predictive of higher mRS. Higher CBF (β = 0.660, p = 0.003) and RTAP (β = 1.528, p = 0.010), and lower SD RTAP (β = −0.709, p = 0.016), RTPP (β = −2.132, p = 0.006), and NG (β = −1.036, p = 0.011) were identified as most predictive of k_w through multivariable linear regression analysis.

Conclusions

Lower k_w is predictive of higher mRS in patients with AIS. Increasing CBF and RTAP and lower SD RTAP, RTPP, and NG were correlated with higher k_w.

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来源期刊

Neuroimage-Clinical NEUROIMAGING-

CiteScore

7.50

自引率

4.80%

发文量

368

审稿时长

52 days

期刊介绍： NeuroImage: Clinical, a journal of diseases, disorders and syndromes involving the Nervous System, provides a vehicle for communicating important advances in the study of abnormal structure-function relationships of the human nervous system based on imaging. The focus of NeuroImage: Clinical is on defining changes to the brain associated with primary neurologic and psychiatric diseases and disorders of the nervous system as well as behavioral syndromes and developmental conditions. The main criterion for judging papers is the extent of scientific advancement in the understanding of the pathophysiologic mechanisms of diseases and disorders, in identification of functional models that link clinical signs and symptoms with brain function and in the creation of image based tools applicable to a broad range of clinical needs including diagnosis, monitoring and tracking of illness, predicting therapeutic response and development of new treatments. Papers dealing with structure and function in animal models will also be considered if they reveal mechanisms that can be readily translated to human conditions.