Top row: Selected transverse diffusion-weighted images. Bottom row: Mean transit time maps. Measurement of the volumes of the lesions, only portions of which are shown here, demonstrated a 340 percent diffusion-
perfusion mismatch.

Diffusion-perfusion mismatch commonly persists longer than nine hours after a stroke and occurs most often in patients with proximal arterial occlusion (PAO), researchers have found.

Intravenous thrombolysis is currently administered only to patients who present less than three hours after symptom onset with lesion mismatch on diffusion- and perfusion-weighted MR. William A. Copen, M.D., of Massachusetts General Hospital, and colleagues studied 109 patients who underwent diffusion-weighted and perfusion-weighted imaging within 24 hours of stroke onset. CT or MR angiography distinguished patients with PAO from those without PAO. Researchers found that while patients without PAO demonstrated decreasing eligibility for thrombolysis over time after stroke onset, patients with PAO demonstrated increasing eligibility and showed no significant difference before and more than nine hours following onset.

"For institutions not capable of performing diffusion- and perfusion-weighted imaging on acute stroke patients, the current findings suggest that patients who are scanned after nine hours and have PAO seen on CT angiography or MR angiography may be more likely to have a significant quantity of persistently threatened-but-salvageable brain tissue, and therefore may be more likely to benefit from thrombolysis," the researchers stated.

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Large-Core Breast Biopsy: Abnormal Salivary Cortisol Profiles Associated with Uncertainty of Diagnosis

Green line represents well-adapted slope of µ0.233 ln (µg/dL)/hr. Red line is example of peaked rhythm, with slope of +0.025 ln (µg/dL)/hr. Teal (dashed) line is example of flat rhythm, with slope of µ0.028 ln (µg/dL)/hr.

Anxiety associated with waiting for
histology results after large core breast biopsy can adversely affect biochemical stress levels, researchers have discovered.

"Diurnal salivary cortisol profiles of women who have not heard their diagnoses by day five after large core breast biopsy are abnormal to a degree that is indistinguishable from women who have learned that they have malignant disease," wrote Elvira V. Lang, M.D., of Beth Israel Deaconess Medical Center, and colleagues at the University of Iowa.

The 150 women in the study group learned of their diagnoses one to six days after biopsy. Cortisol slopes of the women with uncertain diagnoses were significantly flatter—less desirable—than those of women who learned earlier that they had benign disease and were not significantly different from those who learned earlier that they had malignant disease.

Distress associated with knowledge of biopsy results or lack thereof is reflected in abnormal salivary cortisol profiles, the researchers note. "Uncertainty about the final diagnosis is associated with significant biochemical distress which may have adverse effects on immune defense and wound healing," they write. "This supports calls for more rapid provision of biopsy results."

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Media Coverage of Radiology

In January, media outlets carried 136 news stories generated by articles appearing in Radiology. These stories reached an estimated 55 million people.

Coverage included HealthScout News, Asian News International, Radiology Today, General Practitioner, Health & Medicine Week, Obesity, Fitness & Wellness Week, Women's Health Weekly, ABCNews.com, MedLinePlus.com, ScienceDaily.com, Auntminnie.com, HealthImaging.com and drkoop.com.

Learn about media coverage of RSNA 2008 here.

March Public Information Activities Focus on Colorectal Cancer

To highlight National Colorectal Cancer Awareness Month in March, RSNA will distribute radio public service announcements (PSAs) encouraging listeners to be screened for colorectal cancer.

In addition, RSNA will distribute the "60-Second Checkup" audio program to nearly 100 radio stations across the U.S. The segments will focus on the RadiologyInfo.org patient information site and also address colorectal cancer topics including early detection of colorectal cancer and the use of virtual colonoscopy.