PRELIMINARY CLINICAL-RADIOLOGICAL ASSESSMENT OF A MR TISSUE SIGNATUREMODEL IN HUMAN STROKE

We evaluated the ability of an MR signature model (SM) of cerebral isc hemic injury to stage the evolution of cellular damage in human stroke . In 19 patients with ischemic stroke of presumed embolic or non-embol ic cause we carried out diffusion-weighted and T-2-weighted MR imaging within 48 h of onset, and obtained apparent diffusion coefficient of water (ADC(w)), and T-2 weighted images. We used the signatures obtain ed from these ADC(w)/T-2 maps to formulate two patterns of damage sign ifying accelerated or non-accelerated progression of cellular death af ter stroke onset. Those patients with the accelerated pattern correspo nded to those with the neuroradiological (NRC) and clinical diagnosis (TOAST.1 and TOAST.2) of presumed embolic stroke, with clinical diagno sis performed blinded both to NRC and to SM. Agreement between the SM and NRC was substantial (kappa=0.62), moderate (0.60<kappa<0.40) betwe en the SM or NRC and TOAST.2, and fair (0.40<kappa<0.20) among the SM or NRC and TOAST.1. We believe these results constitute a preliminary validation of the MR tissue signature modeling in clinical stroke asse ssment. (C) 1998 Elsevier Science B.V.