title: Comparison of susceptibility-weighted and perfusion-weighted magnetic resonance imaging in the detection of penumbra in acute ischemic stroke.
abstract: OBJECTIVE
  To investigate detection of ischemic penumbra in stroke patients with acute cerebral infarction by susceptibility-weighted imaging (SWI) in comparison with perfusion-weighted imaging (PWI).
  
  
  METHODS
  This study included 18 stroke patients with acute infarction who underwent diffusion-weighted imaging (DWI), SWI, PWI, and magnetic resonance angiography (MRA) within 3 days after symptom onset. The Alberta Stroke Program Early CT Score (ASPECTS) was used to evaluate lesions on DWI, SWI, and PWI. DWI-SWI and DWI-PWI mismatches were calculated.
  
  
  RESULTS
  The DWI-SWI mismatch was not significantly different from the DWI-mean transit time (MTT) mismatch (P=0.163) in evaluating ischemic penumbra. The susceptibility vessel sign (SVS) in SWI occurred in 11 (61%) of 18 patients with cerebral infarction. Stenosis or occlusion of the affected vessels was identified by MRA in 10 (91%) of the 11 SVS-positive patients. The SVS on SWI was significantly associated with the occurrence of damaged vessels or the presence of thrombus in the affected vessels (P=0.047).
  
  
  CONCLUSIONS
  DWI-SWI mismatch is a good marker for evaluating ischemic penumbra in stroke patients with cerebral infarction. SWI can detect thrombus in the affected vessels, and may be useful for guiding intra-arterial thrombolytic therapy.
authors.affiliation: Department of Neurology, the First Hospital of Bengbu Medical College, Bengbu 233004, China. Electronic address: 542462407@qq.com.
authors.forename: Song
authors.initials: S
authors.lastname: Luo
authors.affiliation: Department of Pediatrics, the First Hospital of Bengbu Medical College, Bengbu 233004, China.
authors.forename: Lijuan
authors.initials: L
authors.lastname: Yang
authors.affiliation: Department of Psychology, Bengbu Medical College, Bengbu 233000, China.
authors.forename: Lijin
authors.initials: L
authors.lastname: Wang
mesh_terms: D000328:Adult; D001921:Brain / Q000473:pathology*; D038524:Diffusion Magnetic Resonance Imaging / Q000379:methods*; D005260:Female; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D018810:Magnetic Resonance Angiography / Q000379:methods*; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D020521:Stroke / Q000473:pathology*; D055815:Young Adult
keywords: Diffusion-weighted imaging; Penumbra; Perfusion-weighted imaging; Stroke; Susceptibility-weighted imaging