title: Evaluation of mean diffusion and kurtosis MRI mismatch in subacute ischemic stroke: Comparison with NIHSS score.
abstract: Neurological deterioration (ND) is a devastating complication following ischemic stroke. This study aimed to identify the differences in lesion characteristics in subacute ischemic stroke patients with and without ND using diffusional kurtosis imaging (DKI), as well as to confirm the responsible lesions that may lead to ND, as assessed by the National Institutes of Health Stroke Scale (NIHSS) score. Seventy-nine patients with subacute cerebral infarction were allocated to the ND (-) and ND (+) groups according to the NIHSS score and lesion number. The mean diffusion (MD) lesions were significantly larger than the mean kurtosis (MK) deficits in the ND (+) group (P<0.05); however, there was no significant difference in the ND (-) group (P>0.05). The MD and MK in the lesion recovered to normal levels over time; however, the recovery trends in the ND (+) group were substantially slower than the ND (-) group. The differences between the two groups were only significant regarding the MK (p<0.05). Furthermore, multiple infarction lesions exhibited good consistency in the ND (-) group, but were non-homogeneous in the ND (+) group. To the best of our knowledge, this is the first study to demonstrate that a significant MD/MK mismatch and heterogeneity of multiple ischemic lesions on MK in subacute ischemic stroke may represent a new expansion of an ischemic lesion or acute reinfarction, which is closely related to ND.
authors.affiliation: Department of Radiology, The 2nd Affiliated Hospital, Shantou University Medical College, Shantou, 515000 Guangdong, China.
authors.forename: Yue-Lin
authors.initials: YL
authors.lastname: Guo
authors.affiliation: GE Healthcare, Guangzhou 510623, Guangdong, China.
authors.forename: Zhong-Ping
authors.initials: ZP
authors.lastname: Zhang
authors.affiliation: Engineering College Shantou University, Shantou, 515000 Guangdong, China.
authors.forename: Gui-Shan
authors.initials: GS
authors.lastname: Zhang
authors.affiliation: Department of Radiology, The 2nd Affiliated Hospital, Shantou University Medical College, Shantou, 515000 Guangdong, China.
authors.forename: Ling-Mei
authors.initials: LM
authors.lastname: Kong
authors.affiliation: Department of Radiology, The 2nd Affiliated Hospital, Shantou University Medical College, Shantou, 515000 Guangdong, China.
authors.forename: Hai-Bing
authors.initials: HB
authors.lastname: Rao
authors.affiliation: Department of Neurology, The 2nd Affiliated Hospital, Shantou University Medical College, Shantou, 515000 Guangdong, China.
authors.forename: Wei
authors.initials: W
authors.lastname: Chen
authors.affiliation: Department of Neurology, The 2nd Affiliated Hospital, Shantou University Medical College, Shantou, 515000 Guangdong, China.
authors.forename: Guang-Wen
authors.initials: GW
authors.lastname: Wang
authors.affiliation: Department of Radiology, The 2nd Affiliated Hospital, Shantou University Medical College, Shantou, 515000 Guangdong, China.
authors.forename: Zhi-Wei
authors.initials: ZW
authors.lastname: Shen
authors.affiliation: Department of Radiology, The 2nd Affiliated Hospital, Shantou University Medical College, Shantou, 515000 Guangdong, China.
authors.forename: Wen-Bin
authors.initials: WB
authors.lastname: Zheng
authors.affiliation: Department of Radiology, The 2nd Affiliated Hospital, Shantou University Medical College, Shantou, 515000 Guangdong, China. Electronic address: rhwu@stu.edu.cn.
authors.forename: Ren-Hua
authors.initials: RH
authors.lastname: Wu
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001921:Brain / Q000000981:diagnostic imaging* / Q000473:pathology*; D002545:Brain Ischemia / Q000150:complications / Q000000981:diagnostic imaging* / Q000473:pathology*; D003627:Data Interpretation, Statistical; D003936:Diagnosis, Computer-Assisted; D038524:Diffusion Magnetic Resonance Imaging / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009460:Neurologic Examination; D012720:Severity of Illness Index; D020521:Stroke / Q000150:complications / Q000000981:diagnostic imaging* / Q000473:pathology*
keywords: Diffusion; Ischemia; Kurtosis; Magnetic resonance imaging; NIHSS score; Stroke