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Diffusion weighted imaging, apparent diffusion coefficient maps and stroke etiology.

L H Bonati1, P A Lyrer, S G Wetzel

  • 1Dept. of Neurology and Stroke Unit, University Hospital Basel, Petersgraben 4, 4031 Basel, Switzerland. bonatil@uhbs.ch

Journal of Neurology
|June 9, 2005
PubMed
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Multiple ischemic lesions are more frequent in large artery atherosclerosis (LAA) stroke than cardioembolic (CE) stroke. Apparent diffusion coefficient (ADC) maps help differentiate lesion patterns, especially for cardioembolic strokes affecting multiple circulations.

Area of Science:

  • Neurology
  • Radiology
  • Stroke Pathogenesis

Background:

  • Diffusion-weighted imaging (DWI) lesion characteristics in acute ischemic stroke can indicate underlying causes.
  • Large artery atherosclerosis (LAA) and cardioembolism (CE) are common stroke etiologies with distinct pathogenetic mechanisms.

Purpose of the Study:

  • To investigate differences in DWI lesion features between LAA and CE stroke.
  • To evaluate the utility of apparent diffusion coefficient (ADC) maps in characterizing these lesions.

Main Methods:

  • Retrospective analysis of 83 acute ischemic stroke patients (40 LAA, 43 CE).
  • Characterization of DWI lesions by number, size, distribution, and ADC map signal intensity.
  • Comparison of all hyperintense DWI lesions and acute lesions (hypointense on ADC maps).

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Main Results:

  • Multiple hyperintense DWI lesions were significantly more frequent in LAA stroke (28/40) than CE stroke (21/43).
  • Lesion number was higher in LAA stroke (4.7±4.9) versus CE stroke (3.1±4.7).
  • Acute lesions in multiple circulations were observed only in CE stroke (7%), not in LAA stroke.

Conclusions:

  • Multiple ischemic lesions on DWI are more common in LAA stroke compared to CE stroke.
  • ADC maps are crucial for comparing DWI lesion patterns and identifying cardioembolic strokes affecting multiple circulations.