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Embolic cerebral infarction: MR findings in the first 3 hours after onset
E Shimosegawa1, A Inugami, T Okudera
1Department of Radiology and Nuclear Medicine, Research Institute of Brain and Blood Vessels-Akita, Japan.
Objective:
MR imaging has a high sensitivity for detecting ischemic brain parenchyma. The aim of this study was to evaluate the changes in the signal intensity of infarcted brain parenchyma on MR images obtained within the first 3 hr after the onset of signs and symptoms in patients with embolic cerebral infarction.
Materials And Methods:
We studied MR images of 16 patients who had a diagnosis of embolic cerebral infarction (highly probable according to criteria of the National Institute of Neurological and Communicative Disorders and Stroke). T1-weighted, T2-weighted, and proton density-weighted MR images were obtained within 3 hr after the onset of symptoms. Two neuroradiologists who had no knowledge of the diagnoses reviewed the MR images of these 16 patients and 20 control subjects in random order and evaluated signal-intensity changes in the gray and white matter.
Results:
On proton density-weighted images, the central and cortical gray matter showed increased signal intensity in 63-69% and 88-94% of the patients, respectively. No abnormalities of the brain parenchyma were apparent on T1-weighted and T2-weighted images obtained within 3 hr after the onset of symptoms. The adjacent white matter appeared hyperintense on long TR images in only a few cases.
Conclusion:
An increased signal intensity in the gray matter on proton density-weighted images was the most characteristic parenchymal change seen on MR images of the brain obtained within 3 hr after embolic cerebral infarction.
Insights
Early MR imaging within 3 hours of embolic cerebral infarction shows characteristic signal changes. Proton density-weighted MRI reveals increased gray matter signal intensity, aiding in early diagnosis of stroke.
Area of Science:
- Neurology
- Radiology
- Medical Imaging
Background:
- Magnetic Resonance (MR) imaging is sensitive for detecting ischemic brain parenchyma.
- Early detection of embolic cerebral infarction is crucial for timely intervention.
Purpose of the Study:
- To evaluate signal intensity changes in infarcted brain parenchyma on MR images within 3 hours of embolic cerebral infarction onset.
- To identify characteristic MR imaging findings in acute embolic stroke.
Main Methods:
- MR imaging (T1-weighted, T2-weighted, proton density-weighted) was performed on 16 patients with embolic cerebral infarction within 3 hours of symptom onset.
- Images were reviewed by neuroradiologists for signal intensity changes in gray and white matter, comparing with 20 control subjects.
Main Results:
- Increased signal intensity in gray matter (central and cortical) was observed on proton density-weighted images in a significant percentage of patients (63-94%).
- No abnormalities were apparent on T1-weighted and T2-weighted images within the first 3 hours.
- Adjacent white matter showed hyperintensity in only a few cases on long TR images.
Conclusions:
- Increased gray matter signal intensity on proton density-weighted MR images is the most characteristic finding within 3 hours of embolic cerebral infarction.
- Proton density-weighted imaging is valuable for early detection of acute embolic stroke.