(Stroke. 2001;32:950.)
© 2001 American Heart Association, Inc.
Original Contributions |
Multiparametric MRI Tissue Characterization in Clinical Stroke With Correlation to Clinical Outcome
Part 2
From the Departments of Neurology (M.A.J., P.M., S.S., M.C.), Radiology, Medical Image Analysis Research (M.A.J., H.S-Z., A.G., R.H., D.J.P), and Neuroradiology (S.P.), Henry Ford Health Sciences Center, Detroit, Mich; Department of Electrical and Computer Engineering, University of Tehran (Iran) (H.S-Z.); Department of Physics, Oakland University, Rochester, Mich (M.A.J., M.C.); and Department of Radiology, The Johns Hopkins University School of Medicine, Baltimore, Md (M.A.J.).
Correspondence to Michael Chopp, PhD, Department of Neurology, Center for Stroke Research, Henry Ford Hospital E&R 3056, 2799 W Grand Blvd, Detroit, MI 48202. E-mail chopp{at}neuro.hfh.edu
Background and Purpose—Multiparametric MRI generates different zones within the lesion that may reflect heterogeneity of tissue damage in cerebral ischemia. This study presents the application of a novel model of tissue characterization based on an angular separation between tissues obtained with the use of an objective (unsupervised) computer segmentation algorithm implementing a modified version of the Iterative Self-Organizing Data Analysis Technique (ISODATA). We test the utility of this model to identify ischemic tissue in clinical stroke.
Methods—MR
parameters diffusion-, T2-, and T1-weighted imaging (DWI,
T2WI, and T1WI, respectively) were obtained from 10 patients at 3 time
points (30 studies) after stroke: acute (
12 hours), subacute (3
to 5 days), and chronic (3 months). The National Institutes of Health
Stroke Scale (NIHSS) was measured, and volumes were obtained from the
ISODATA, DWI, and T2WI maps on patients at each time
point.
Results—The acute (12
hours) multiparametric ISODATA volume was significantly
correlated with the acute (12 hours) DWI
(r=0.96,
P<0.05; n=10) and chronic (3
months) T2WI volume (r=0.69,
P<0.05; n=10). The
ISODATA-defined tissue regions exhibited MR indices consistent
with ischemic and/or infarcted tissue at each time point. The
acute (12 hours) multiparametric ISODATA volumes were
significantly correlated
(r=0.82,
P<0.009; n=10) with the
final NIHSS score. In comparison, the acute (12 hours) DWI volumes
were less correlated (r=0.77,
P<0.05; n=10) and T2WI volume
(12h) exhibited a marginal correlation
(r=0.66,
P<0.05; n=10) with the final
NIHSS score.
Conclusions—The integrated ISODATA approach to tissue segmentation and classification discriminated abnormal from normal tissue at each time point. The ISODATA volume was significantly correlated with the current MR standards used in the clinical setting and the 3-month clinical status of the patient.
Key Words: cerebral ischemia, focal • diagnostic imaging • diffusion imaging • magnetic resonance imaging • signal processing, computer assisted, ISODATA • stroke, acute • stroke classification
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