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Serial study of apparent diffusion coefficient and anisotropy in patients with acute stroke
Q Yang1, B M Tress, P A Barber
1Department of Radiology, Royal Melbourne Hospital and University of Melbourne, Victoria, Australia. QY@radior.medrmh.unimelb.edu.au
Stroke
|November 5, 1999
Summary
Apparent diffusion coefficient (ADC) and apparent diffusion anisotropy (ADA) show varied patterns during stroke evolution. Early ADA changes in acute ischemia may help predict patient outcomes.
Area of Science:
- Neuroimaging
- Diffusion MRI
- Stroke Research
Background:
- Acute stroke involves complex cellular changes impacting water diffusion.
- Characterizing diffusion changes aids in understanding stroke progression.
Purpose of the Study:
- To characterize the evolution of apparent diffusion coefficient (ADC) and apparent diffusion anisotropy (ADA) in acute stroke.
- To evaluate the predictive role of ADC and ADA in stroke evolution and patient outcomes.
Main Methods:
- Studied 26 acute stroke patients at three time points: acute (<24h), subacute (3-5 days), and outcome (3 months).
- Evaluated ADC and ADA ratios within infarcts compared to normal contralateral regions.
- Correlated diffusion parameters with clinical scales: Canadian Neurological Scale, Barthel Index, and Rankin Scale.
Main Results:
- Observed heterogeneous evolution patterns of ADC and ADA, both between patients and within lesions.
- Identified three distinct phases of diffusion abnormalities based on ADC and ADA changes.
- Early ADA ratios correlated significantly with acute and subacute neurological status and long-term functional outcomes (Barthel Index, Rankin Scale).
Conclusions:
- Combined ADC and ADA provide differential patterns reflecting stroke evolution.
- Early ADA alterations indicate cellular changes in acute ischemia.
- ADA may serve as a potential imaging biomarker for predicting stroke outcomes.