How To’s – DSC & Perfusion

This How To uses the “StrokeDWIPWI” Case of the local DataBase. The goal is to get the mismatch percentage between DWI and PWI in a Stroke Case, with automated identifying of the involved arterial territories, the Global and Local Stroke Volumes, all these informations in Dicomizable Reports.

Part I: The DWI:

First in the “DataBase” Tab, click on the patient name “StrokeDWIPWI”, then the serie date “20100714” then double-click on the “DIFF SENSE” serie name. The DWI serie will be loaded and displayed:

Then go the the “Series Processing” Tab, in the “Diffusion” Tab, and click on “Stroke”:

The software will do batch processes such as Brain Extraction, Coregistration to Template, will compute the ADC Map:

and from DWI and ADC will detect the involved Vascular Territories, and will generate a Stroke Map of Ischemia (red) and Penumbra (green) in DWI:

as well as the DWI Stroke Report (see at the end of this page), which can be displayed as described here.

Once done, you can navigate through the Stroke Map from the “MPR” mode in the “MPR/3D Display” Tab by clicking on the Rendered window, or change Display Mode to switch to “Mosaic” by clicking on the “MPR/3D” button:

to go to the “Mosaic” mode:

or to “3D” VR Mode by clicking again on the “MPR/3D” button:

Stroke3DStrokeMap

Going into DataBase, you can load and display the ADC map by double-clicking on the “ADC_Reg_Msk_DIFF_SENSE-Map”:

Part II: The PWI:

Once the DWI is done, you can process the PWI serie. Go to the “DataBase” Tab, click on the patient name “StrokeDWIPWI”, serie date “20100714” and double-click on the serie name “PERF DD 30 CPES” to load and display the PWI serie:

Now go to the “Series Processing” Tab, in the “DSC & Perm.” Tab, and click on “Stroke”:

The software will do Batch processes such as Brain Extraction, Motion Correction:

Then Registering to Template, extracting the AIF:

Then computing DSC Parameters: TTP, TMax, BAT, CBV, CBF, MTT:

and Permeability Parameters: fBV and kPS.

Then the software will compute the mismatch between the Stroke Map generated by the DWI Process, and the MTT map:

and will generate a PWI Stroke Report, which can be displayed as described here, of the Stroke Volume of the involved Arterial Territories, and of the quantified DWI/PWI Mismatch (see the pdf file below).

thumbnail-of-DWI Stroke Report

DWI Stroke Report

thumbnail-of-PWI Stroke Report

PWI Stroke Report