[Diffusion-weighted MRT in vertebrobasilar ischemia. Application, sensitivity, and prognostic value].

Area of Science:

• Neurology
• Radiology
• Medical Imaging

Background:

• Vertebrobasilar ischemia presents with acute signs and symptoms.
• Accurate and timely diagnosis is crucial for effective treatment.

Purpose of the Study:

• To assess the utility, sensitivity, and predictive value of diffusion-weighted MR imaging (DWI) for diagnosing vertebrobasilar infarction.
• To compare DWI with CT scanning and high-resolution MRI.

Main Methods:

• Prospective recruitment of 268 patients with suspected vertebrobasilar ischemia (1997-2002).
• Patients underwent biplanar EPI-T2 and EPI DWI within 24 hours of symptom onset.
• Control imaging included high-resolution MRI within 7 days and CT scanning in 121 patients.

Main Results:

• DWI detected acute vertebrobasilar infarction in 71.0% of patients.
• DWI revealed significantly more acute lesions than CT imaging (28.0%) and was comparable in time to CT.
• High-resolution MRI did not identify additional lesions beyond DWI.
• In patients with transient ischemic attack (TIA) or reversible ischemic neurological deficit (PRIND), DWI showed acute ischemia in 42.8%.
• Normal DWI in 63 patients predicted complete recovery or minimal symptoms within one week.

Conclusions:

• Diffusion-weighted MR imaging (DWI) is a highly sensitive method for diagnosing acute vertebrobasilar ischemia.
• DWI is time-efficient, comparable to CT imaging.
• A normal DWI scan serves as a strong predictor of favorable clinical outcomes in patients diagnosed with brainstem or cerebellar infarction.