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Published on: September 20, 2015
The value of apparent diffusion coefficient maps in early cerebral ischemia
P M Desmond1, A C Lovell, A A Rawlinson
1Department of Radiology, Royal Melbourne Hospital and University of Melbourne, Parkville, Victoria 3050, Australia.
AJNR. American Journal of Neuroradiology
|August 11, 2001
Summary
Lowered apparent diffusion coefficient (ADC) values in the ischemic penumbra predict which stroke regions will infarct. These intermediate ADC values indicate tissue at high risk for progression to infarction.
Area of Science:
- Neuroimaging
- Stroke Research
- Diffusion-Weighted Imaging
Background:
- Acute ischemic stroke presents a critical window for intervention.
- Identifying the ischemic penumbra, tissue at risk, is crucial for treatment decisions.
- Predicting penumbra evolution to infarction aids in patient management.
Purpose of the Study:
- To investigate if lowered apparent diffusion coefficient (ADC) values are present in the ischemic penumbra.
- To determine if these ADC values are specific to penumbra regions that progress to infarction.
- To assess the predictive value of ADC for stroke progression.
Main Methods:
- Studied 19 patients with acute hemispheric stroke within 6 hours of onset.
- Utilized serial MRI scans (acute, subacute, and 90-day outcome).
- Compared ADC values in penumbra regions that infarcted versus those that remained normal.
Main Results:
- Significantly reduced ADC ratios (P <.00001) were observed in penumbra regions that progressed to infarction.
- Mean ADC ratios in regions transitioning to infarction ranged from 0.75 to 0.90.
- Lowered ADC values demonstrated specificity for tissue destined to infarct.
Conclusions:
- Intermediate apparent diffusion coefficient (ADC) values are detectable in the ischemic penumbra.
- These intermediate ADC values serve as an indicator of tissue at risk for infarction.
- ADC measurements can help predict stroke progression and identify salvageable brain tissue.
