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J.–Y. Gauvrit,
X. Leclerc, M. Girot,
C. Cordonnier,
G. Sotoares,
H. Henon,
B. Pertuzon,
E. Michelin,
D. Devos,
J.–P. Pruvo,
D. Leys
[show abstract]
[hide abstract]
ABSTRACT: Background and purposeDiffusion–weighted magnetic resonance (MR) imaging (DWI), and three–dimensional (3D) time–of–flight (TOF) MR angiography (MRA),
are highly sensitive for the early detection of stroke and arterial occlusion. However, only a few studies have evaluated
the sensitivity of conventional MR sequences that are usually included in the imaging protocol. The aim of this study was
to evaluate interobserver and intertechnique reproducibility of Fluid–Attenuated Inversion Recovery (FLAIR) sequences for
the diagnosis of early brain ischemia and arterial occlusion.
MethodsOver a 30–month period, brain MR examinations were performed in 34 patients within 12 hours after stroke onset. Imaging protocol
included FLAIR sequences, DWI and 3D TOF MRA. Ten observers including radiologists and neurologists, performed separately
a visual interpretation of FLAIR images for the detection of brain ischemia and arterial occlusion seen as an arterial high
signal. DWI and 3D TOF MRA were used as reference and interpreted independently by two senior radiologists. Interobserver
agreement was assessed for image quality, detectability and conspicuity of lesions whereas intertechnique agreement was only
judged for lesion detectability.
ResultsOn FLAIR sequences, interobserver agreement for the detection of brain ischemia and arterial occlusion was excellent (κ =
0.81 and 0.87 respectively). The concordance between FLAIR and DWI sequences for the detection of brain ischemia and between
FLAIR and 3D TOF MRA for the detection of arterial occlusion were judged as excellent for all observers (κ = 0.91 and 0.89
respectively).
ConclusionAlthough DWI is the most sensitive technique with which to detect acute stroke, FLAIR imaging may also be useful to demonstrate
both acute ischemia and arterial occlusion with an excellent interobserver reproducibility.
Journal of Neurology 04/2006; 253(5):631-635. · 3.47 Impact Factor
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G Breteau,
F Mounier-Vehier,
O Godefroy,
J-Y Gauvrit,
M-A Mackowiak-Cordoliani, M Girot,
D Bertheloot,
H Hénon,
C Lucas,
X Leclerc,
F Fourrier,
J P Pruvo,
D Leys
[show abstract]
[hide abstract]
ABSTRACT: An early diagnosis and heparin therapy have contributed to a decreased mortality in cerebral venous thrombosis (CVT). However, predictors of outcome are difficult to identify, because most studies suffered heterogeneity in diagnostic findings and treatments, retrospective design, and recruitment bias. The aim of this study was to evaluate the clinical outcome in 55 consecutive patients with CVT admitted over a 4-year period. The study population consisted of 42 women and 13 men, with a median age of 39 years (range 16-68). The diagnosis was performed with MRI in 53 patients, and angiography in 2. The outcome was assessed with the modified Rankin scale (mRs). After a median follow-up of 36 months (range: 12-60), 45 patients were independent (mRS 0-2), and 10 were dependent or dead (mRS 3-6). Of 48 survivors, 7 had seizures, 6 motor deficits, 5 visual field defects, 29 headache (migraine in 14, tension headache in 13, other in 2). The logistic regression analysis found focal deficits and cancer at time of diagnosis, as independent predictors of dependence or death at year 3, and isolated intra-cranial hypertension as an independent predictor of survival and independence. Mortality rates are low in the absence of cancer and focal deficits, and more than 80 % of survivors are independent after 3 years. However, 3/4 of survivors have residual symptoms. Therefore, despite a low mortality rate, CVT remains a serious disorder.
Journal of Neurology 02/2003; 250(1):29-35. · 3.47 Impact Factor
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G. Breteau,
F. Mounier-Vehier,
O. Godefroy,
J.-Y. Gauvrit,
M.-A. Mackowiak-Cordoliani, M. Girot,
D. Bertheloot,
H. Hénon,
C. Lucas,
X. Leclerc,
F. Fourrier,
J. P. Pruvo,
D. Leys
[show abstract]
[hide abstract]
ABSTRACT: An early diagnosis and heparin therapy have contributed to a decreased mortality in cerebral venous thrombosis (CVT). However,
predictors of outcome are difficult to identify, because most studies suffered heterogeneity in diagnostic findings and treatments,
retrospective design, and recruitment bias. The aim of this study was to evaluate the clinical outcome in 55 consecutive patients
with CVT admitted over a 4-year period. The study population consisted of 42 women and 13 men, with a median age of 39 years
(range 16–68). The diagnosis was performed with MRI in 53 patients, and angiography in 2. The outcome was assessed with the
modified Rankin scale (mRs). After a median follow-up of 36 months (range: 12–60), 45 patients were independent (mRS 0–2),
and 10 were dependent or dead (mRS 3–6). Of 48 survivors, 7 had seizures, 6 motor deficits, 5 visual field defects, 29 headache
(migraine in 14, tension headache in 13, other in 2). The logistic regression analysis found focal deficits and cancer at
time of diagnosis, as independent predictors of dependence or death at year 3, and isolated intra-cranial hypertension as
an independent predictor of survival and independence. Mortality rates are low in the absence of cancer and focal deficits,
and more than 80 % of survivors are independent after 3 years. However, 3/4 of survivors have residual symptoms. Therefore,
despite a low mortality rate, CVT remains a serious disorder.
Journal of Neurology 12/2002; 250(1):29-35. · 3.47 Impact Factor
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Cerebrovascular Diseases 02/2000; 10 Suppl 4:17-20. · 2.72 Impact Factor
