Diffusion-weighted imaging showing 'Pearls' predicts large-vessel disease as stroke etiology

Cerebrovascular Diseases

Volumn 28, Issue 1, 2009, Pages 49-54

  Turtzo, L Christine ^a   Gottesman, Rebecca F ^b   Llinas, Rafael H ^b,c  

^a UNIVERSITY OF CONNECTICUT HEALTH CENTER   (United States)

^b DEPARTMENT OF PATHOLOGY   (United States)

^c JOHNS HOPKINS BAYVIEW MEDICAL CENTER   (United States)

Author keywords

Diffusion weighted imaging; Etiology; Large vessel atherosclerosis; Magnetic resonance imaging; Stroke

Indexed keywords

ADULT; AGED; ARTERY OCCLUSION; ARTICLE; BRAIN CIRCULATION; CONTROLLED STUDY; DIFFUSION WEIGHTED IMAGING; HOSPITAL ADMISSION; HUMAN; MAJOR CLINICAL STUDY; MEDICAL RECORD REVIEW; NUCLEAR MAGNETIC RESONANCE IMAGING; PATIENT CODING; PREDICTION; PRIORITY JOURNAL; STROKE; TRANSIENT ISCHEMIC ATTACK; UNIVERSITY HOSPITAL;

ADULT; AGED; AGED, 80 AND OVER; CONSTRICTION, PATHOLOGIC; DIFFUSION MAGNETIC RESONANCE IMAGING; HUMANS; INTRACRANIAL ARTERIOSCLEROSIS; ISCHEMIC ATTACK, TRANSIENT; LOGISTIC MODELS; MIDDLE AGED; PREDICTIVE VALUE OF TESTS; RETROSPECTIVE STUDIES; STROKE;

EID: 66049160245     PISSN: 10159770     EISSN: None     Source Type: Journal    
DOI: 10.1159/000219297     Document Type: Article

References (19)

1. Madden KP, Karanjia PN, Adams HP Jr, Clarke WR: Accuracy of initial stroke subtype diagnosis in the toast study. Trial of ORG 10172 in Acute Stroke Treatment. Neurology 1995;45:1975-1979.
2. 2-weighted MRI and spectroscopy. Magn Reson Med 1990; 14: 330-346.
3. Warach S, Chien D, Li W, Ronthal M, Edel- man RR: Fast magnetic resonance diffusion- weighted imaging of acute human stroke. Neurology 1992;42:1717-1723.
4. Warach S, Gaa J, Siewert B, Wielopolski P, Edelman RR: Acute human stroke studied by whole brain echo planar diffusion-weighted magnetic resonance imaging. Ann Neurol 1995;37:231-241.
5. Altieri M, Metz RJ, Muller C, Maeder P, Meuli R, Bogousslavsky J: Multiple brain in- farcts: clinical and neuroimaging patterns using diffusion-weighted magnetic resonance. Eur Neurol 1999;42:76-82.
6. Baird AE, Lovblad KO, Schlaug G, Edelman RR, Warach S: Multiple acute stroke syndrome: marker of embolic disease? Neurology 2000;54:674-678.
7. Roh JK, Kang DW, Lee SH, Yoon BW, Chang KH: Significance of acute multiple brain infarction on diffusion-weighted imaging. Stroke 2000;31:688-694.
8. Koennecke HC, Bernarding J, Braun J, Faulstich A, Hofmeister C, Nohr R, Leistner S, Marx P: Scattered brain infarct pattern on diffusion-weighted magnetic resonance imaging in patients with acute ischemic stroke. Cerebrovasc Dis 2001;11:157-163.
9. Kang DW, Chu K, Ko SB, Kwon SJ, Yoon BW, Roh JK: Lesion patterns and mechanism of ischemia in internal carotid artery disease: a diffusion-weighted imaging study. Arch Neurol 2002;59:1577-1582.
10. Kang DW, Chalela JA, Ezzeddine MA, Warach S: Association of ischemic lesion patterns on early diffusion-weighted imaging with toast stroke subtypes. Arch Neurol 2003;60:1730-1734.
11. Lee PH, Bang OY, Oh SH, Joo IS, Huh K: Sub- cortical white matter infarcts: comparison of superficial perforating artery and internal border-zone infarcts using diffusion-weighted magnetic resonance imaging. Stroke 2003;34:2630-2635.
12. Engelter ST, Wetzel SG, Radue EW, Rausch M, Steck AJ, Lyrer PA: The clinical significance of diffusion-weighted MR imaging in infratentorial strokes. Neurology 2004; 62:574-580.
13. Bonati LH, Lyrer PA, Wetzel SG, Steck AJ, Engelter ST: Diffusion-weighted imaging, apparent diffusion coefficient maps and stroke etiology. J Neurol 2005; 252:1387-1393.
14. Wessels T, Wessels C, Ellsiepen A, Reuter I, Trittmacher S, Stolz E, Jauss M: Contribution of diffusion-weighted imaging in determination of stroke etiology. AJNR Am J Neuroradiol 2006; 27: 35-39.
15. Warach S, Edelman RR: The 'string of pearls sign' - a sign of watershed infarctions by diffusion-weighted MRI. Proc 34th Annu Meet Am Soc Neuroradiol 1996, p 180.
16. Chalela JA, Kang D-W, Latour LL, Warach S: String of pearls sign on diffusion MRI is associated with large artery atherosclerosis (poster 7). Am Stroke Assoc Int Stroke Conf, Phoenix, 2003.
17. Adams HP Jr, Bendixen BH, Kappelle LJ, Biller J, Love BB, Gordon DL, Marsh EE 3rd:Classification of subtype of acute ischemic stroke: definitions for use in a multicenter clinical trial. Toast. Trial of ORG 10172 in Acute Stroke Treatment. Stroke 1993; 24: 35-41.
18. Stata Corp: Stata statistical software release 8.0. College Station, Stata, 2002.
19. Gottesman RF, Sherman PM, Grega MA, Yousem DM, Borowicz LM Jr, Selnes OA, Baumgartner WA, McKhann GM: Watershed strokes after cardiac surgery: diagnosis, etiology, and outcome. Stroke 2006;37:2306-2311.