[Subacute cerebral infarct: native and contrast medium-enhanced MRT].

Area of Science:

• Neurology
• Radiology
• Medical Imaging

Background:

• Cerebral infarction diagnosis often relies on clinical presentation and CT scans.
• Magnetic Resonance (MR) imaging offers detailed anatomical visualization.
• The role of contrast agents in MR for stroke detection requires further clarification.

Purpose of the Study:

• To evaluate the diagnostic utility of MR imaging with Gadolinium-Diethylenetriaminepentaacetic acid (Gd-DTPA) contrast enhancement in patients with suspected supratentorial cerebral infarct.
• To compare T2-weighted MR sequences with postcontrast T1-weighted sequences in detecting and characterizing infarcts.
• To assess the added value of Gd-DTPA in differentiating infarct stages and identifying subtle lesions.

Main Methods:

• Prospective study of 25 patients with clinical and CT-confirmed supratentorial cerebral infarct.
• MR examinations performed between day 3 and 150 post-stroke.
• Comparison of T2-weighted axial images with T1-weighted sequences after intravenous Gd-DTPA administration.

Main Results:

• T2-weighted images detected parenchymal lesions in all 25 patients.
• Postcontrast T1-weighted images showed pathologic enhancement in 19 infarcts.
• Gd-DTPA provided additional diagnostic information in 5 patients, revealing typical ischemic gyral enhancement, and aided in differentiating infarct chronicity in one patient.

Conclusions:

• MR imaging with Gd-DTPA is recommended for suspected cerebral infarction when clinical findings and CT are equivocal.
• Contrast-enhanced MR can reveal infarcts not clearly depicted on non-contrast sequences.
• Gd-DTPA enhances the detection and characterization of ischemic lesions, improving diagnostic accuracy.