Evolution of MR contrast enhancement patterns during the first week after acute ischemic stroke

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J O Karonen1, P L Partanen, R L Vanninen

  • 1Department of Clinical Radiology, Kuopio University Hospital, Finland.

AJNR. American Journal of Neuroradiology
|February 13, 2001
PubMed
Abstract

Insights

Contrast-enhanced MRI reveals evolving enhancement patterns in ischemic stroke patients. While intravascular enhancement decreases, parenchymal enhancement increases over the first week, aiding infarct age determination.

Area of Science:

  • Neurology
  • Radiology
  • Medical Imaging

Background:

  • Contrast-enhanced T1-weighted MRI and diffusion-weighted MRI (DWI) are used to detect changes in ischemic stroke.
  • Enhancement patterns, both intravascular and parenchymal, are observed in patients with ischemic stroke.

Purpose of the Study:

  • To investigate MR enhancement findings during the first week post-stroke.
  • To determine if early intravascular enhancement predicts infarct growth.

Main Methods:

  • 48 patients with ischemic stroke underwent MRI (T1-weighted with gadolinium and DWI) on days 1, 2, and 7.
  • Enhancement patterns (intravascular and parenchymal) were categorized and compared with DWI findings.

Main Results:

  • Intravascular enhancement was present in 78% on days 1 and 2, decreasing to 30% at 1 week.
  • Parenchymal enhancement increased from 26% on day 1 to 100% at 1 week.
  • Early intravascular enhancement did not predict infarct growth.

Conclusions:

  • MR contrast enhancement patterns can help determine infarct age.
  • Intense parenchymal enhancement may complicate diagnosis with obscure clinical history.

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