![]() 1 Positive results from the Endovascular Therapy Following Imaging Evaluation for Ischemic Stroke 3 (DEFUSE 3) 2 and Clinical Mismatch in the Triage of Wake Up and Late Presenting Strokes Undergoing Neurointervention with Trevo (DAWN) trials 3 have extended the therapeutic windows for AIS.įindings from DWI are important for determining ischemic cores and have been included for assessing infarct volume in randomized clinical trials such as DEFUSE 3 and DAWN. A multicenter randomized clinical trial (Multicenter Randomized Clinical trial of Endovascular treatment for Acute ischemic stroke in the Netherlands the MR CLEAN trial) revealed notable benefits from EVT in patients with AIS. MR imaging is one of the best modalities for diagnosing acute ischemic stroke (AIS) and plays a crucial role in treatment decisions for procedures such as endovascular thrombectomy (EVT). Clinical characteristics of patients with a nondecreased intravoxel incoherent motion perfusion fraction and/or pseudodiffusion coefficient rated by the 2 observers were also assessed.ĪBBREVIATIONS: AIS acute ischemic stroke D diffusion coefficient D* pseudo-diffusion coefficient EVT endovascular thrombectomy f perfusion fraction IVIM intravoxel incoherent motion Interobserver agreement on the rating scale was evaluated using the κ statistic. The presence of decreases in the intravoxel incoherent motion perfusion fraction and pseudodiffusion coefficient values compared with the contralateral normal-appearing brain was graded on a 2-point scale by 2 independent neuroradiologists. From the intravoxel incoherent motion MR imaging data, diffusion coefficient, perfusion fraction, and pseudodiffusion coefficient maps were obtained using a 2-step fitting algorithm based on the Levenberg-Marquardt method. Diffusion-sensitizing gradients were applied sequentially in the x, y, and z directions with 6 different b-values (0, 50, 100, 150, 200, and 1000 seconds/mm 2). Each patient underwent intravoxel incoherent motion MR imaging using a 1.5T MR imaging scanner. ![]() ![]() MATERIALS AND METHODS: We retrospectively studied 29 patients with AIS (17 men, 12 women mean age, 75.2 years median, 77 years).
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