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

J J Marx1, F Thoemke, A Mika-Gruettner

  • 1Klinik und Poliklinik für Neurologie, Johannes-Gutenberg-Universität Mainz. marx@neurologie.klinik.uni-mainz.de

Der Nervenarzt
|April 17, 2004
PubMed
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Diffusion-weighted MR imaging (DWI) is a sensitive tool for diagnosing acute vertebrobasilar infarction. A normal DWI scan predicts a good clinical outcome for patients with brainstem or cerebellar infarction.

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:

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  • 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.