Diamandi Julia, Raimondo Christian, Alizadeh Mahdi, Flanders Adam, Tjoumakaris Stavropoula, Gooch M Reid, Jabbour Pascal, Rosenwasser Robert, Mouchtouris Nikolaos
Department of Neurological Surgery, Thomas Jefferson University Hospital, Philadelphia, PA, United States.
Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, United States.
Magn Reson Imaging. 2025 Apr;117:110290. doi: 10.1016/j.mri.2024.110290. Epub 2024 Dec 2.
To evaluate the Mean Apparent Propagator (MAP) MRI for processing multi-shell diffusion imaging in patients with acute ischemic stroke (AIS) and correlate to diffusion tensor imaging (DTI) and neurite orientation and dispersion density imaging (NODDI).
We enrolled patients with AIS from 1/2022 to 4/2024 who underwent multi-shell diffusion imaging on a 3.0-Tesla scanner to generate DTI, NODDI and MAP measures. Mean intensity and standard deviation (SD) were calculated for the infarcted regions-of-interest in b0, fractional anisotropy (FA), mean diffusivity (MD), intra-cellular volume fraction (ICVF), free water fraction (FWF), and orientation dispersion index (ODI), return to the origin probability (RTOP), return to the plane probability (RTPP), return to the axis probability (RTAP), propagator anisotropy (PA), q-space Mean Square Displacement (QMSD), and non-Gaussianity (NG).
Twenty-two patients were included with an average age of 69.5 ± 13.5, mean NIHSS of 12.4 ± 7.7, and median infarct of 73.3 ± 10.1 ml. ICVF was correlated with RTPP (ρ = 0.82, p < 0.01), RTAP (ρ = 0.76, p < 0.01) and RTOP (ρ = 0.79, p < 0.01), ODI with PA (ρ = -0.83, p < 0.01), FWF with RTOP (ρ = -0.73, p < 0.01), RTAP (ρ = -0.69, p < 0.01), and RTPP (ρ = -0.73, p < 0.01), MD with RTPP (ρ = -0.80, p < 0.01), RTOP (ρ = -0.79, p < 0.01), and RTAP (ρ = -0.77, p < 0.01), FA with RTAP (ρ = 0.77, p < 0.01), RTOP (ρ = 0.67, p = 0.01), PA (ρ = 0.74, p < 0.01), and SD PA (ρ = 0.85, p < 0.01). Multivariable linear regression identified the SD QMSD (β = 0.406, p = 0.008), thrombectomy (β = 0.481, p = 0.002), and infarct volume (β = 0.292, p = 0.051) as predictive of stroke severity based on NIHSS.
Given its short processing time, MAP MRI is a valuable alternative with potential for clinical use in AIS.
评估平均表观传播子（MAP）磁共振成像（MRI）在急性缺血性脑卒中（AIS）患者中处理多壳层扩散成像的情况，并与扩散张量成像（DTI）、神经突方向和分散密度成像（NODDI）进行关联。
我们纳入了2022年1月至2024年4月期间在3.0特斯拉扫描仪上接受多壳层扩散成像以生成DTI、NODDI和MAP测量值的AIS患者。计算梗死感兴趣区域在b0图像中的平均强度和标准差（SD）、分数各向异性（FA）、平均扩散率（MD）、细胞内体积分数（ICVF）、自由水分数（FWF）、方向分散指数（ODI）、返回原点概率（RTOP）、返回平面概率（RTPP）、返回轴概率（RTAP）、传播子各向异性（PA）、q空间均方位移（QMSD）和非高斯性（NG）。
纳入22例患者，平均年龄69.5±13.5岁，美国国立卫生研究院卒中量表（NIHSS）平均评分为12.4±7.7分，梗死中位数为73.3±10.1毫升。ICVF与RTPP（ρ = 0.82，p < 0.01）、RTAP（ρ = 0.76，p < 0.01）和RTOP（ρ = 0.79，p < 0.01）相关，ODI与PA（ρ = -0.83，p < 0.01）相关，FWF与RTOP（ρ = -0.73，p < 0.01）、RTAP（ρ = -0.69，p < 0.01）和RTPP（ρ = -0.73）相关，MD与RTPP（ρ = -0.80，p < 0.01）、RTOP（ρ = -0.79，p < 0.01）和RTAP（ρ = -0.77，p < 0.01）相关，FA与RTAP（ρ = 0.77，p < 0.01）、RTOP（ρ = 0.67，p = 0.01）、PA（ρ = 0.74，p < 0.01）和SD PA（ρ = 0.85，p < 0.01）相关。多变量线性回归确定SD QMSD（β = 0.406，p = 0.008）、血栓切除术（β = 0.481，p = 0.002）和梗死体积（β = 0.292，p = 0.051）可作为基于NIHSS的卒中严重程度的预测指标。
鉴于其处理时间短，MAP MRI是一种有价值的替代方法，在AIS中具有临床应用潜力。
