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[MR of ischemic brain diseases. A comparison with CT, PET (18-fluorodeoxyglucose) and angiographic results]
Abstract:
The results of MRI and CT in 55 patients with brain infarcts were compared; in 26 of these cases an additional PET examination was obtained in order to study the regional glucose utilisation. MRI was superior to CT, demonstrating 11% more of the infarcts, particularly during the first 24 hours, in small lesions confined to the grey or subcortical white matter and in infratentorial ischemic lesion. On the other hand, only CT was able to show fresh hemorrhage, although MRI was the method of choice to demonstrate old blood collections. To characterise the follow up of an infarct, CT and MRI were similar, except the marginal contrast enhancement sometimes demonstrated by CT studies between the 2nd and 4th week after stroke event. PET was inferior to show details because of its poorer spatial resolution, but anyhow had a high sensitivity and provided additional informations concerning secondary inactivations of brain areas not directly damaged. Additionally PET was able to demonstrate areas of anaerobic glycolysis and lesions of diminished glucose utilisation in TIAs. Small areas of gliosis in the white matter of the cerebral hemispheres were frequently found in patients with cerebro-vascular diseases; they were best shown by MRI, but do not correlate with the extent of vascular stenoses or occlusions, shown by angiography.
Insights
Magnetic Resonance Imaging (MRI) and Computed Tomography (CT) effectively detect brain infarcts, with MRI showing more lesions. Positron Emission Tomography (PET) offers functional insights into glucose metabolism and secondary brain changes.
Area of Science:
- Neuroradiology
- Neuroimaging
- Cerebrovascular Disease
Background:
- Brain infarcts are a significant cause of neurological disability.
- Accurate imaging is crucial for diagnosis, characterization, and management of stroke.
- Comparing the diagnostic capabilities of different neuroimaging modalities is essential.
Purpose of the Study:
- To compare the efficacy of Magnetic Resonance Imaging (MRI) and Computed Tomography (CT) in detecting brain infarcts.
- To evaluate the utility of Positron Emission Tomography (PET) in assessing regional glucose utilization in patients with brain infarcts.
- To investigate the role of these imaging techniques in characterizing infarct evolution and associated findings.
Main Methods:
- Retrospective analysis of neuroimaging studies in 55 patients with brain infarcts.
- Comparison of MRI and CT findings for infarct detection and characterization.
- Inclusion of PET scans in 26 patients to assess regional glucose metabolism.
Main Results:
- MRI demonstrated 11% more infarcts than CT, particularly in early stages (first 24 hours), small lesions, and infratentorial infarcts.
- CT was superior for detecting acute hemorrhage, while MRI excelled at visualizing chronic blood collections.
- PET provided functional information on glucose utilization, secondary brain inactivation, and anaerobic glycolysis, despite lower spatial resolution than MRI/CT.
Conclusions:
- MRI is generally superior to CT for detecting brain infarcts, especially in the acute phase and for specific lesion types.
- CT remains valuable for identifying acute hemorrhage, while MRI is preferred for old hemorrhage.
- PET offers complementary functional information regarding metabolic changes and secondary effects in cerebrovascular disease.