Association of cerebral microvascular perfusion and diffusion dynamics detected by intravoxel incoherent motion-diffusion weighted imaging with initial neurological function and clinical outcome in acute ischemic stroke

Fei Chen; Zhenyu Dai; Lizheng Yao; Congsong Dong; Haicun Shi; Weiqiang Dou; Wei Xing

doi:10.7717/peerj.12196

Association of cerebral microvascular perfusion and diffusion dynamics detected by intravoxel incoherent motion-diffusion weighted imaging with initial neurological function and clinical outcome in acute ischemic stroke

PeerJ. 2021 Sep 16:9:e12196. doi: 10.7717/peerj.12196. eCollection 2021.

Authors

Fei Chen^#^{1

2}, Zhenyu Dai^#², Lizheng Yao², Congsong Dong², Haicun Shi³, Weiqiang Dou⁴, Wei Xing¹

Affiliations

¹ Department of Radiology, The Third Affiliated Hospital of Soochow University, Changzhou, Jiangsu, China.
² Department of Radiology, Yancheng Third People's Hospital, Yancheng, Jiangsu, China.
³ Department of Neurology, Yancheng Third People's Hospital, Yancheng, Jiangsu, China.
⁴ GE Healthcare, MR Research China, Bejing, China.

^# Contributed equally.

Abstract

Background: This work aimed to explore the association of cerebral microvascular perfusion and diffusion dynamics measured by intravoxel incoherent motion (IVIM) imaging with initial neurological function and clinical outcome in acute stroke.

Methods: In total, 39 patients were assessed with admission National Institutes of Health Stroke Scale (NIHSS) and day-90 modified Rankin Scale (mRS). The parametrical maps of IVIM were obtained, including apparent diffusion coefficient (ADC), pseudo-diffusion coefficient (D*), true diffusion coefficient (D) and perfusion fraction (f). The fD* was the product of f and D*. Moreover, the ratios of lesioned/contralateral parameters (rADC, rD, rD*, rf and rfD*) were also obtained. The differences of these parameters between the poor outcome group and good outcome group were evaluated. Partial correlation analysis was used to evaluate the correlations between the admission NIHSS/day-90 mRS and each parameter ratio, with lesion volumes controlled.

Results: The ADC, D, D*, f and fD* values of lesions were significantly reduced than those of the contralateral regions. The rADC and rD were significantly decreased in the poor outcome group than good outcome group (all p < 0.01). With lesion volume controlled, rADC showed a weak negative correlation (r = -0.340, p = 0.037) and a notable negative correlation (r = -0.688, p < 0.001) with admission NIHSS score and day-90 mRS score, respectively. In addition, rD showed a strong negative correlation (r = -0.731, p < 0.001) with day-90 mRS score.

Conclusion: Significant negative correlations were revealed between IVIM derived diffusion dynamics parameters and initial neurological function as well as clinical outcome for patients with acute ischemic stroke. IVIM can be therefore suggested as an effective non-invasive method for evaluating the acute ischemic stroke.

Keywords: Diffusion weighted imaging; Intravoxel incoherent motion; Magnetic resonance imaging; Perfusion; Stroke.

Grants and funding

This work was supported by the National Natural Science Foundation of China (No. 81601161), the Programs of Scientific Research Project of Jiangsu Commission of Health of China (Nos. H2018092 and H2019088), the Foundation Plan for Outstanding People of The Sixth Peak of Jiangsu Province of China (No. 2019-WSN-313), the Foundation Plan for The Fifth Scientific Research Project of “333 Project” of Jiangsu Province of China (No. BRA2019031), and the Medical and Scientific Development Program of Yancheng of Jiangsu Province of China (Nos. YK2018119 and YK 2019106). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.