scholarly journals Does Diffusion Tensor Imaging-Based Tractography at 3 Months of Age Contribute to the Prediction of Motor Outcome After Perinatal Arterial Ischemic Stroke?

Stroke ◽  
2011 ◽  
Vol 42 (12) ◽  
pp. 3410-3414 ◽  
Author(s):  
Niek E. van der Aa ◽  
Alexander Leemans ◽  
Frances J. Northington ◽  
Henrica L. van Straaten ◽  
Ingrid C. van Haastert ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Diffusion Tensor Imaging ◽  
Positive Predictive Value ◽  
Predictive Value ◽  
Neonatal Period ◽  
Motor Behavior ◽  
Diffusion Tensor ◽  
Motor Deficits ◽  
Arterial Ischemic Stroke ◽  
Perinatal Arterial Ischemic Stroke

Background and Purpose— After perinatal arterial ischemic stroke, diffusion-weighted imaging (DWI) and early evaluation of spontaneous motor behavior can be used to predict the development of unilateral motor deficits. The aim of this study was to investigate whether diffusion tensor imaging-based tractography at 3 months of age contributes to this prediction. Methods— Twenty-two infants with unilateral perinatal arterial ischemic stroke were included and scanned during the neonatal period. DWI was used to assess restricted diffusion in the cerebral peduncle. At the age of 3 months, diffusion tensor imaging-based tractography of the corticospinal tracts was performed along with assessment of the movement repertoire. The role of DWI, diffusion tensor imaging, and motor assessment in predicting unilateral motor deficits were compared by calculating the positive and negative predictive values for each assessment. Results— Eleven infants (50%) showed abnormal motor behavior at 3 months with subsequent development of unilateral motor deficits in 8 as determined at follow-up (9–48 months, positive predictive value 73%). Diffusion tensor imaging-based tractography correctly predicted the development of unilateral motor deficits in all 8 infants (positive predictive value 100%). A diagnostic neonatal DWI was available in 20 of 22 (91%) infants. Seven infants showed an abnormal DWI, resulting in unilateral motor deficits in 6 infants (positive predictive value 86%). All assessments had a negative predictive value of 100%. Conclusions— Diffusion tensor imaging-based tractography at 3 months can be used to predict neurodevelopmental outcome after perinatal arterial ischemic stroke. It has a similar predictive value as DWI in the neonatal period and can especially be of additional value in case of an indecisive neonatal DWI or unexpected abnormal early motor development.

scholarly journals Diffusion Is Directional: Innovative Diffusion Tensor Imaging to Improve Prostate Cancer Detection

Diagnostics ◽  
2021 ◽  
Vol 11 (3) ◽  
pp. 563
Author(s):  
Chen Shenhar ◽  
Hadassa Degani ◽  
Yaara Ber ◽  
Jack Baniel ◽  
Shlomit Tamir ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Diffusion Tensor Imaging ◽  
Predictive Value ◽  
Breast Imaging ◽  
Normal Tissue ◽  
Diffusion Tensor ◽  
Peripheral Zone ◽  
Predictive Values ◽  
Directional Diffusion ◽  
Central Gland

In the prostate, water diffusion is faster when moving parallel to duct and gland walls than when moving perpendicular to them, but these data are not currently utilized in multiparametric magnetic resonance imaging (mpMRI) for prostate cancer (PCa) detection. Diffusion tensor imaging (DTI) can quantify the directional diffusion of water in tissue and is applied in brain and breast imaging. Our aim was to determine whether DTI may improve PCa detection. We scanned patients undergoing mpMRI for suspected PCa with a DTI sequence. We calculated diffusion metrics from DTI and diffusion weighted imaging (DWI) for suspected lesions and normal-appearing prostate tissue, using specialized software for DTI analysis, and compared predictive values for PCa in targeted biopsies, performed when clinically indicated. DTI scans were performed on 78 patients, 42 underwent biopsy and 16 were diagnosed with PCa. The median age was 62 (IQR 54.4–68.4), and PSA 4.8 (IQR 1.3–10.7) ng/mL. DTI metrics distinguished PCa lesions from normal tissue. The prime diffusion coefficient (λ1) was lower in both peripheral-zone (p < 0.0001) and central-gland (p < 0.0001) cancers, compared to normal tissue. DTI had higher negative and positive predictive values than mpMRI to predict PCa (positive predictive value (PPV) 77.8% (58.6–97.0%), negative predictive value (NPV) 91.7% (80.6–100%) vs. PPV 46.7% (28.8–64.5%), NPV 83.3% (62.3–100%)). We conclude from this pilot study that DTI combined with T2-weighted imaging may have the potential to improve PCa detection without requiring contrast injection.

Evaluating ischemic stroke with diffusion tensor imaging

2008 ◽  
Vol 30 (7) ◽  
pp. 720-726 ◽  
Author(s):  
Ziqian Chen ◽  
Ping Ni ◽  
Jing Zhang ◽  
Youqiang Ye ◽  
Hui Xiao ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Diffusion Tensor Imaging ◽  
Diffusion Tensor

Neurocognitive outcome in a 6-year-old girl with a history of perinatal stroke

2011 ◽  
Vol 26 (S2) ◽  
pp. 1100-1100
Author(s):  
A. Matos-Pires ◽  
N. Cardoso-Pereira
Keyword(s):  
Working Memory ◽  
Ischemic Stroke ◽  
Verbal Learning ◽  
Arterial Ischemic Stroke ◽  
Intellectual Performance ◽  
Perinatal Stroke ◽  
Intellectual Outcome ◽  
History Of ◽  
Perinatal Arterial Ischemic Stroke

Perinatal Stroke involves an often poorly understood neurocognitive events affecting the fetus and the new born with a potential for serious intellectual outcome.Our aim is to present a case study on the issue of neurocognitive defects on domains such as intellectual performance, attention and vigilance, executive functioning, visual perception, speed of processing, verbal learning and memory, and working memory on a 6 year old girl with perinatal arterial ischemic stroke.

scholarly journals Risk of Later Seizure After Perinatal Arterial Ischemic Stroke: A Prospective Cohort Study

PEDIATRICS ◽  
2011 ◽  
Vol 127 (6) ◽  
pp. e1550-e1557 ◽  
Author(s):  
C. J. Wusthoff ◽  
S. K. Kessler ◽  
A. Vossough ◽  
R. Ichord ◽  
S. Zelonis ◽  
...  
Keyword(s):  
Cohort Study ◽  
Ischemic Stroke ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Arterial Ischemic Stroke ◽  
Perinatal Arterial Ischemic Stroke

Abstract TP221: Using Berlin Questionnaire and Epworth Sleepiness Scale to Identify Stroke Patients at Risk for the Sleep Apnea Syndrome

Stroke ◽  
2013 ◽  
Vol 44 (suppl_1) ◽  
Author(s):  
Millene Camilo ◽  
Alan Eckeli ◽  
Heidi Sander ◽  
Regina Fernandes ◽  
Joao Leite ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Ischemic Stroke ◽  
Sleep Apnea ◽  
Positive Predictive Value ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Epworth Sleepiness Scale ◽  
Berlin Questionnaire ◽  
Stroke Patients ◽  
Obstructive Sleep

Background: Sleep-disordered breathing (SDB) is frequent in the acute phase of stroke. Obstructive sleep apnea (OSA) has been found in 62% of stroke patients. The impact of OSA is significant after ischemic stroke, including early neurological deterioration, poor functional outcome and increased long-term mortality. However, performing polysomnography (PSG) for all patients with acute stroke for diagnose OSA is still impracticable. Therefore clinical tools to select patients at higher risk for OSA would be essential. The aim of this study was to determine the validity of the Berlin Questionnaire (BQ) and the Epworth Sleepiness Scale (ESS) to identify stroke patients in whom the PSG would be indicated. Methods: Subjects with ischemic stroke were stratified into high and low risk groups for SDB using a BQ. The ESS ≥ 10 was used to define excessive daytime sleepiness. The BQ and ESS were administered to the relatives of stroke patients at hospital admission. All patients were submitted to a full overnight PSG at the first night after symptoms onset. OSA severity was measured by the apnea-hypopnea index (AHI). Results: We prospectively studied 40 ischemic stroke patients. The mean age was 62 ± 12.1 years and the obstructive sleep apnea (AHI ≥ 15) was present in 67.5%. On stratifying risk of OSA in these patients based on the QB, 77.5% belonged to the high-risk and 50% to the ESS ≥ 10. The sensitivity of QB was 85%, the specificity 35%, the positive predictive value 74% and the negative predictive value 55%. For ESS was respectively 63%, 85%, 89% and 52%. The diagnostic value of the BQ and ESS in combination to predict OSA had a sensitivity of 58%, a specificity of 89%, a positive predictive value of 95% and a negative predictive value of 38%. Conclusions: The QB even applied to the bed-partners of stroke patients is a useful screening tool for OSA.

scholarly journals Automatic Segmentation of Perinatal Arterial Ischemic Stroke Volume

2011 ◽  
Vol 70 ◽  
pp. 155-155
Author(s):  
N E van der Aa ◽  
I Isgum ◽  
F Groenendaal ◽  
M A Viergever ◽  
L S de Vries ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Stroke Volume ◽  
Automatic Segmentation ◽  
Arterial Ischemic Stroke ◽  
Perinatal Arterial Ischemic Stroke

scholarly journals Epilepsy in children with perinatal arterial ischemic stroke

2021 ◽  
Author(s):  
Fabienne Kühne ◽  
Alexander Jungbluth ◽  
Joanna Schneider ◽  
Christoph Bührer ◽  
Christine Prager ◽  
...  
Keyword(s):  
Cerebral Palsy ◽  
Ischemic Stroke ◽  
Neonatal Period ◽  
Refractory Epilepsy ◽  
Late Onset ◽  
Cognitive Outcome ◽  
Response To Treatment ◽  
Arterial Ischemic Stroke ◽  
Structural Epilepsy ◽  
Drug Refractory Epilepsy

Purpose: Perinatal ischemic stroke (PIS) is a frequent cause for perinatal brain structure defects resulting in epilepsy, cerebral palsy and disability. Since the severity of symptoms is variable, the aim of this study was to evaluate the outcome of children with PIS and seizures/epilepsy to aid parental counseling and therapy decisions. Material: We studied retrospectively patients with arterial PIS and structural epilepsy or seizures in the newborn treated at a single center in 2000-2019. Specifically, signs and symptoms of cerebral palsy (CP), developmental and motor delay, epilepsy and thrombophilia were assessed. Results: From the identified 69 individuals with arterial PIS, we only included the 50 patients (64% male) who had structural epilepsy at the time of investigation or previously in their medical history.The mean age of the included patients was 7.1 years (range 0.08-22) at last consultation. Infarct localisation was predominantly unilateral (86%), left sided (58%) and affecting the middle cerebral artery (94%). Genetic thrombophilia was identified in 52% of the patients examined with genetic testing. More than half of the individuals had CP (52%), and 38.5% had a cognitive outcome below average. First seizures occurred in the neonatal period in 58% of patients and developed into drug-refractory epilepsy in 24.1%. Children with late-onset of epilepsy were twice as likely to develop drug-refractory epilepsy (52.4%). Discussion: Our study shows that patients with PIS and seizures as common sequela often also develop CP. Children with later onset of epilepsy have a worse outcome. Patients with seizure onset in the neonatal period and reccuring seizures have a good response to treatment. Therefore, early diagnosis, follow-up examination and adequate therapy are important. Most children need intensive physiotherapy and speech therapy; however, participation in life is usually age-appropriate.

Diffusion tensor imaging in children following prenatal myelomeningocele repair and its predictive value for the need and timing of subsequent CSF diversion surgery for hydrocephalus

2021 ◽  
Vol 27 (4) ◽  
pp. 391-399
Author(s):  
Weihong Yuan ◽  
Charles B. Stevenson ◽  
Mekibib Altaye ◽  
Blaise V. Jones ◽  
James Leach ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Regression Analysis ◽  
Diffusion Tensor Imaging ◽  
Logistic Regression Analysis ◽  
Predictive Value ◽  
Diffusion Tensor ◽  
Linear Regression Analysis ◽  
Model Performance ◽  
Time Interval ◽  
Csf Diversion

OBJECTIVE The aim of this study was to investigate diffusion tensor imaging (DTI), an objective and noninvasive neuroimaging technique, for its potential as an imaging biomarker to predict the need and timing of CSF diversion surgery in patients after prenatal myelomeningocele (MMC) repair. METHODS This was a retrospective analysis of data based on 35 pediatric patients after prenatal MMC repair (gestational age at birth 32.68 ± 3.42 weeks, range 24–38 weeks; 15 females and 20 males). A logistic regression analysis was used to classify patients to determine the need for CSF diversion surgery. The model performance was compared between using the frontooccipital horn ratio (FOHR) alone and using the FOHR combined with DTI values (the genu of the corpus callosum [gCC] and the posterior limb of the internal capsule [PLIC]). For patients who needed to be treated surgically, timing of the procedure was used as the clinical outcome to test the predictive value of DTI acquired prior to surgery based on a linear regression analysis. RESULTS Significantly lower fractional anisotropy (FA) values in the gCC (p = 0.014) and PLIC (p = 0.037) and higher mean diffusivity (MD) values in the gCC (p = 0.013) were found in patients who required CSF diversion surgery compared with those who did not require surgery (all p values adjusted for age). Based on the logistic regression analysis, the FOHR alone showed an accuracy of performance of 0.69 and area under the receiver operating characteristic curve (AUC) of 0.60. The performance of the model was higher when DTI measures were used in the logistic regression model (accuracy = 0.77, AUC = 0.84 for using DTI values in gCC; accuracy = 0.75, AUC = 0.84 for using DTI values in PLIC). Combining the DTI values of the gCC or PLIC and FOHR did not improve the model performance when compared with using the DTI values alone. In patients who needed CSF diversion surgery, significant correlation was found between DTI values in the gCC and the time interval between imaging and surgery (FA: ρ = 0.625, p = 0.022; MD: ρ = −0.6830, p = 0.010; both adjusted for age and FOHR). CONCLUSIONS The authors’ data demonstrated that DTI could potentially serve as an objective biomarker differentiating patients after prenatal MMC repair regarding those who may require surgery for MMC-associated hydrocephalus. The predictive value for the need and timing of CSF diversion surgery is highly clinically relevant for improving and optimizing decision-making for the treatment of hydrocephalus in this patient population.

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