A New Image-Based Stroke Registry Containing Quantitative Magnetic Resonance Imaging Data

作者：Kim Dong Eog^*; Park Kyoung Jong; Schellingerhout Dawid; Jeong Sang Wuk; Ji Myung Goo; Choi Won Jun; Tak Yoon Oh; Kwan Geon Hwan; Koh Eun Ah; Noh Sang Mi; Jang Hyung Yeol; Kim Tae Yun; Jeong Ji Won; Lee Jae Sung; Choi Heung Kook

来源：Cerebrovascular Diseases, 2011, 32(6): 567-576.

DOI：10.1159/000331934

• Alphanumeric data
• Image-based stroke registry
• Quantitative magnetic resonance imaging data

Background: Conventional stroke registries contain alphanumeric text-based data on the clinical status of stroke patients, but this format captures imaging data in a very limited form. There is a need for a new type of stroke registry to capture both text-and image-based data. Methods and Results: We designed a next-generation stroke registry containing quantitative magnetic resonance imaging(MRI) data, 'DUIH_SRegI', developed a supporting software package, 'Image_QNA', and performed experiments to assess the feasibility and utility of the system. Image_QNA enabled the mapping of stroke-related lesions on MR onto a standard brain template and the storage of this extracted imaging data in a visual database. Interuser and intrauser variability of the lesion mapping procedure was low. We compared the results from the semi automatic lesion registration using Image_QNA with automatic lesion registration using SPM5 (Statistical Parametric Mapping version 5), a well-regarded standard neuroscience software package, in terms of lesion location, size and shape, and found Image_QNA to be superior. We assessed the clinical usefulness of an image-based registry by studying 47 consecutive patients with first-ever lacunar infarcts in the corona radiata. We used the enriched dataset comprised of both image-based and alphanumeric databases to show that diffusion MR lesions overlapped in a more posterolateral brain location for patients with high NIH Stroke Scale scores (>= 4) than for patients with low scores (<= 3). In April 2009, we launched the first prospective image-based acute (<= 1 week) stroke registry at our institution. The registered data include high signal intensity ischemic lesions on diffusion, T-2-weighted, or fluid attenuation inversion recovery MRIs, and low signal intensity hemorrhagic lesions on gradient-echo MRIs. An interim analysis at 6 months showed that the time requirement for the lesion registration (183 consecutive patients, 3,226 MR slices with visible stroke-related lesions) was acceptable at about 1 h of labor per patient by a trained assistant with physician oversight. Conclusions: We have developed a novel image-based stroke registry, with database functions that allow the formulation and testing of intuitive, image-based hypotheses in a manner not easily achievable with conventional alphanumeric stroke registries.

• 出版日期2011