Overestimation of ischemic core on baseline MRI in acute stroke

• Published in: Interventional neuroradiology 2024-01, p.15910199231224500
• Main Authors: McArthur, M A, Tavakkol, E, Bahr-Hosseini, M, Jahan, R, Duckwiler, G R, Saver, J L, Liebeskind, D S, Nael, K
• Format: Article
• Language: English
• Subjects: Original
• ISSN: 1591-0199; 2385-2011; 2385-2011
• DOI: 10.1177/15910199231224500

In patients with acute ischemic stroke (AIS), overestimation of ischemic core on MRI-DWI has been described primarily in regions with milder reduced diffusion. We aimed to assess the possibility of ischemic core overestimation on pretreatment MRI despite using more restricted reduced diffusion (apparent diffusion coefficient (ADC) ≤620 × 10  mm ) in AIS patients with successful reperfusion. In this retrospective single institutional study, AIS patients who had pretreatment MRI underwent successful reperfusion and had follow-up MRI to determine the final infarct volume were reviewed. Pretreatment ischemic core and final infarction volumes were calculated. Ghost core was defined as overestimation of final infarct volume by baseline MRI of >10 mL. Baseline clinical, demographic, and treatment-related factors in this cohort were reviewed. A total of 6/156 (3.8%) patients had overestimated ischemic core volume on baseline MRI, with mean overestimation of 65.6 mL. Three out of six patients had pretreatment ischemic core estimation of >70 mL, while the final infarct volume was