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[The temporal changes in the diffusion coefficients in stroke].

S Flacke1, H Urbach, E Keller

  • 1Radiologische Universitätsklinik Bonn. flacke@uni.bonn.de

Rofo : Fortschritte Auf Dem Gebiete Der Rontgenstrahlen Und Der Nuklearmedizin
|May 7, 1999
PubMed
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Apparent diffusion coefficient (ADC) values can determine stroke age. Combining diffusion-weighted imaging (DWI) and other MRI sequences aids in diagnosing infarcts at various stroke stages.

Area of Science:

  • Neurology
  • Radiology
  • Medical Imaging

Background:

  • Ischemic stroke diagnosis and age determination are critical for effective treatment.
  • Diffusion-weighted imaging (DWI) provides early detection of ischemic changes.
  • Understanding temporal ADC changes aids in characterizing stroke evolution.

Purpose of the Study:

  • To analyze the temporal changes of apparent diffusion coefficient (ADC) values in ischemic stroke.
  • To evaluate the utility of ADC values in determining stroke age.
  • To assess the combined diagnostic value of DWI and conventional MRI sequences.

Main Methods:

  • Region of interest analysis of ADC maps in 92 ischemic stroke patients.
  • Utilized 1.5 Tesla MRI with DWI (b=0, 189, 750 s/mm-2), GraSE, and FLAIR-TSE sequences.

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  • Compared MRI findings with CT scans; 8 patients had regular follow-ups.

    • Main Results:

    • Relative ADC in the infarct core decreased by ~50% in hyperacute stroke (<6h) and reached a minimum in the acute state (6-48h).
    • ADC values significantly increased in the subacute stage (<3 weeks) and normalized in the chronic stage (>3 weeks).
    • Combined DWI and conventional MRI improved diagnostic information in 16% of cases beyond hyperacute assessment.

    Conclusions:

    • ADC values are effective in determining the age of a stroke.
    • DWI, FLAIR-TSE, and GraSE sequences facilitate diagnosis of infarcts at different stages.
    • Combined imaging approaches help avoid pitfalls associated with DWI and conventional MRI alone.