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Diffusion-weighted magnetic resonance imaging in acute stroke

K J van Everdingen1, J van der Grond, L J Kappelle

  • 1Department of Radiology, University Hospital Utrecht, The Netherlands. K.vanEverdingen@rrn.azu.nl

Stroke
|September 10, 1998
PubMed
Summary

Diffusion-weighted MRI (DWI) detects early stroke lesions better than conventional MRI. Lesion volume on DWI and apparent diffusion coefficient (ADC) predict patient outcomes.

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Area of Science:

  • Neurology
  • Radiology
  • Medical Imaging

Background:

  • Acute stroke requires sensitive detection of cerebral ischemic changes.
  • Conventional MRI techniques have limitations in early stroke detection.

Purpose of the Study:

  • Compare the sensitivity of Diffusion-weighted MRI (DWI) with conventional MRI for acute stroke.
  • Investigate the prognostic value of ischemic lesion volume and apparent diffusion coefficient (ADC) on DWI.

Main Methods:

  • 42 acute stroke patients and 15 controls underwent DWI, FLAIR, T2-weighted, and PD-weighted MRI.
  • Ischemic lesion volume measured on early and follow-up MRI scans.
  • Clinical outcomes assessed using NIH Stroke Scale, Barthel Index, and Rankin Scale at 4 months.

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Main Results:

  • DWI detected 98% of lesions; FLAIR detected 91%; T2-weighted 71%; PD-weighted 80%.
  • Early DWI lesion volume significantly correlated with clinical outcomes (P<0.01).
  • Mean ADC was 29% lower in lesions (P<0.001); ADC ratio correlated with outcomes (P<0.05).

Conclusions:

  • DWI is superior to conventional MRI for detecting early ischemic lesions in stroke.
  • DWI lesion size and ADC values are potential predictors of clinical outcome in acute stroke.