Stroke. 2010 Apr;41(4):814-6. doi: 10.1161/STROKEAHA.109.570358. Epub 2010 Feb 11.
Lesion volume measurements in disabling ischemic stroke have excellent reliability, but it is not clear whether this is also true for small lesions. We assessed the reliability of measuring baseline and follow-up lesion volumes in transient ischemic attack and minor stroke.
Patients who presented with a transient ischemic attack or minor stroke (NIHSS < or = 3) who had brain MRI within 24 hours from symptom onset and at 30-day follow-up and had an acute lesion on baseline MRI were included. Using semiautomated software, 4 stroke fellows independently assessed ischemic lesions twice on acute diffusion-weighted imaging and follow-up fluid-attenuated inversion recovery.
Eighty patients were included, with a median baseline NIHSS of 1. Mean baseline diffusion-weighted imaging lesion volume was 3.4+/-7.4 mL (87.5% had <5 mL). There was excellent inter-rater/intrarater reliability, with intraclass correlation coefficients of 0.94/0.96 for acute diffusion-weighted imaging, 0.74/0.92 for follow-up fluid-attenuated inversion recovery, and 0.81/0.93 for growth.
We found excellent concordance between and within raters for acute diffusion-weighted imaging and 30-day follow-up fluid-attenuated inversion recovery lesion volume measurements in patients with transient ischemic attack and minor stroke.
在致残性缺血性卒中患者中，病灶体积测量具有极好的可靠性，但对于小病灶是否也如此尚不清楚。我们评估了短暂性脑缺血发作和小卒中患者基线和随访时病灶体积测量的可靠性。
本研究纳入了在症状发作后 24 小时内且在 30 天随访时进行了脑部 MRI 检查且基线 MRI 上存在急性病灶的、以短暂性脑缺血发作或小卒中（NIHSS <或= 3）为首发症状的患者。4 名卒中研究员使用半自动软件对急性弥散加权成像和随访时液体衰减反转恢复上的缺血性病灶进行了两次独立评估。
共纳入 80 例患者，基线 NIHSS 的中位数为 1 分。平均基线弥散加权成像病灶体积为 3.4+/-7.4 mL（87.5%的病灶体积<5 mL）。观察者间和观察者内的可靠性均极好，急性弥散加权成像的组内相关系数为 0.94/0.96，随访时液体衰减反转恢复的组内相关系数为 0.74/0.92，病灶生长的组内相关系数为 0.81/0.93。
我们发现，在短暂性脑缺血发作和小卒中患者中，急性弥散加权成像和 30 天随访时液体衰减反转恢复的病灶体积测量具有极好的观察者间和观察者内一致性。
