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Related Experiment Videos

Diffusion-weighted MRI in cortical ischaemia.

K O Lövblad1, S G Wetzel, T Somon

  • 1Unité de Neuroradiologie, Service de Radiodiagnostic, DRRI, Hôpital Cantonal Un iversitaire de Genève, 24 rue Micheli-du-Crest, 1211 Geneva 14, Switzerland. Karl-Olof.Lovblad@hcuge.ch

Neuroradiology
|January 30, 2004
PubMed
Summary
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Diffusion-weighted imaging (DWI) detects early signs of cortical ischemia in comatose patients, revealing changes missed by conventional MRI. This technique aids in diagnosing severe ischemia and predicting patient outcomes.

Area of Science:

  • Neuroimaging
  • Neurology
  • Radiology

Background:

  • Comatose patients with suspected cortical ischemia require accurate and timely diagnosis.
  • Conventional MRI sequences like T2-weighted imaging may underestimate or miss early ischemic changes.
  • Diffusion-weighted imaging (DWI) offers higher sensitivity for detecting acute tissue injury.

Purpose of the Study:

  • To evaluate the utility of diffusion-weighted imaging (DWI) in diagnosing cortical ischemia in comatose patients.
  • To compare DWI findings with conventional T2-weighted imaging in this patient population.
  • To assess the correlation between DWI findings and patient outcomes.

Main Methods:

  • Magnetic Resonance Imaging (MRI) including DWI and conventional sequences was performed on 19 comatose patients.

Related Experiment Videos

  • DWI parameters included b-values of 0 and 1000 s/mm², 5-mm slice thickness, and whole-brain coverage.
  • Apparent Diffusion Coefficient (ADC) maps were generated to quantify diffusion changes.

    • Main Results:

    • DWI revealed high signal intensity in cortical, basal ganglia, and watershed areas in all patients, with ADC values reduced by 60-80%.
    • DWI detected lesions not visualized or underestimated on T2-weighted imaging in 80% of cases.
    • Early DWI changes, within 24 hours of symptom onset, were often not apparent on T2-weighted images.

    Conclusions:

    • DWI is a sensitive technique for detecting early cortical ischemia and associated ADC changes in comatose patients.
    • DWI findings suggest severe ischemia rather than edema in areas typical for cortical laminar necrosis.
    • Extension of ischemic changes to the brain stem and white matter on DWI correlates with a higher mortality risk.