Please use this identifier to cite or link to this item: https://ahro.austin.org.au/austinjspui/handle/1/16324
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dc.contributor.authorWouters, Anke-
dc.contributor.authorDupont, Patrick-
dc.contributor.authorNorrving, Bo-
dc.contributor.authorLaage, Rico-
dc.contributor.authorThomalla, Götz-
dc.contributor.authorAlbers, Gregory W-
dc.contributor.authorThijs, Vincent-
dc.contributor.authorLemmens, Robin-
dc.date2016-09-06-
dc.date.accessioned2016-10-03T05:25:52Z-
dc.date.available2016-10-03T05:25:52Z-
dc.date.issued2016-10-01-
dc.identifier.citationStroke 2016; 47(10): 2559-2564en_US
dc.identifier.urihttps://ahro.austin.org.au/austinjspui/handle/1/16324-
dc.description.abstractBACKGROUND AND PURPOSE: Acute stroke patients with unknown time of symptom onset are ineligible for thrombolysis. The diffusion-weighted imaging and fluid-attenuated inversion recovery (FLAIR) mismatch is a reasonable predictor of stroke within 4.5 hours of symptom onset, and its clinical usefulness in selecting patients for thrombolysis is currently being investigated. The accuracy of the visual mismatch rating is moderate, and we hypothesized that the predictive value of stroke onset within 4.5 hours could be improved by including various clinical and imaging parameters. METHODS: In this study, 141 patients in whom magnetic resonance imaging was obtained within 9 hours after symptom onset were included. Relative FLAIR signal intensity was calculated in the region of nonreperfused core. Mean Tmax was calculated in the total region with Tmax >6 s. Mean relative FLAIR, mean Tmax, lesion volume with Tmax >6 s, age, site of arterial stenosis, core volume, and location of infarct were analyzed by logistic regression to predict stroke onset time before or after 4.5 hours. RESULTS: Receiver-operating characteristic curve analysis revealed an area under the curve of 0.68 (95% confidence interval 0.59-0.78) for the visual diffusion-weighted imaging/FLAIR mismatch, thereby correctly classifying 69% of patients with an onset time before or after 4.5 hours. Age, relative FLAIR, and Tmax increased the accuracy significantly (P<0.01) to an area under the curve of 0.82 (95% confidence interval 0.74-0.89). This new predictive model correctly categorized 77% of patients according to stroke onset before versus after 4.5 hours. CONCLUSIONS: In patients with unknown stroke onset, the accuracy of predicting time from symptom onset within 4.5 hours is improved by obtaining relative FLAIR and perfusion imaging.en_US
dc.subjectFluid-attenuated inversion recovery imagingen_US
dc.subjectPerfusion imagingen_US
dc.subjectPredictionen_US
dc.subjectThrombolysisen_US
dc.subjectTime-windowen_US
dc.titlePrediction of stroke onset is improved by relative fluid-attenuated inversion recovery and perfusion imaging compared to the visual diffusion-weighted imaging/fluid-attenuated inversion recovery mismatchen_US
dc.typeJournal Articleen_US
dc.identifier.journaltitleStrokeen_US
dc.identifier.affiliationDepartment of Neurosciences, Experimental Neurology and Leuven Research Institute for Neuroscience and Disease (LIND), Leuven, Belgiumen_US
dc.identifier.affiliationKU Leuven-University of Leuven, Leuven, Belgiumen_US
dc.identifier.affiliationVIB, Vesalius Research Center, Laboratory of Neurobiology, B-3000 Leuven, Belgiumen_US
dc.identifier.affiliationDepartment of Neurology, University Hospitals Leuven, Leuven, Belgiumen_US
dc.identifier.affiliationLaboratory for Cognitive Neurology, KU Leuven, Leuven, Belgiumen_US
dc.identifier.affiliationDepartment of Clinical Sciences, Section of Neurology, Lund University, Swedenen_US
dc.identifier.affiliationGuided Development GmbH, Heidelberg, Germanyen_US
dc.identifier.affiliationUniversitätsklinikum Hamburg-Eppendorf, Klinik und Poliklinik für Neurologie, Kopf-und Neurozentrum, Hamburg, Germanyen_US
dc.identifier.affiliationStroke Center, Stanford University, Palo Alto, CAen_US
dc.identifier.affiliationDepartment of Neurology Austin Health, Heidelberg, Victoria, Australiaen_US
dc.identifier.affiliationMelbourne Brain Center, Florey Institute of Neuroscience and Mental Health, Heidelberg, Victoria, Australiaen_US
dc.identifier.pubmedurihttps://pubmed.ncbi.nlm.nih.gov/27601375en_US
dc.identifier.doi10.1161/STROKEAHA.116.013903en_US
dc.type.contentTexten_US
dc.type.austinJournal Articleen_US
item.openairecristypehttp://purl.org/coar/resource_type/c_18cf-
item.cerifentitytypePublications-
item.fulltextNo Fulltext-
item.grantfulltextnone-
item.openairetypeJournal Article-
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