Clinical evaluation of the diagnosis of neuronal reversibility with acute cerebral infarction using ADC by diffusion weighted echo planar imaging

The possibility of diagnosing neuronal reversibility with acute cerebral infarction was studied using ADC measured by diffusion weighted imaging (DWI). The subjects were eleven patients who underwent DWI within 24 hours of onset. The area of abnormal signal on DWI during the acute stage was visually compared with that on T2-WI in the subacute phase. ADC was calculated in the two different abnormal areas on DWI, which were differentiated by the presence or absence of abnormality on T2-WI in the subacute phase. The abnormal signals of three cases showed an obviously narrowed area on DWI in the acute phase compared with the abnormality on T2-WI in the sub-acute phase. ADCs of the ischemic areas in DWI abnormalities that showed no abnormality on subacute T2-WI were slightly higher than those of the infarct areas with remaining abnormal signals on T2-WI. However, no statistically significant difference was found between these two regions, because there were large variations within each pixel. We considered that the diagnosis of neuronal reversibility in acute cerebral infarction was difficult using ADC values only and that other parameters such as perfusion or blood volume will be necessary to improve diagnostic quality prior to determining therapy.