Diffusion-weighted imaging in ischaemic stroke: a follow-up study |
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Authors: | J Weber H P Mattle O Heid L Remonda G Schroth |
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Institution: | (1) Department of Neuroradiology, University of Essen, Hufelandstrasse 55, 45122 Essen, Germany e-mail: johannes.weber@uni-essen.de, Tel.: + 49-2 01-7 23 15 42, Fax: + 49-2 01-7 23 15 42, DE;(2) Department of Neurology, Inselspital, University of Berne, Berne, Switzerland, CH;(3) Department of Neuroradiology, Inselspital, University of Berne, Berne, Switzerland, CH |
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Abstract: | Diffusion-weighted (DWI) echo-planar (EPI) MRI has been used for imaging acute ischaemic stroke. We used DWI and conventional
spin-echo (SE) MRI to study the dynamics of ischaemic human stroke. We examined 30 patients (mean age 57.5 years, range 27–82
years, median 57 years) with a diagnosis of stroke. They were examined in the acute (120 min to 47 h, mean 15.3 h), subacute
(8 days) and chronic (2–3 months) stages of ischaemia using clinical scores and MRI. Imaging was performed on an 1.5-T imager.
Anisotropic DWI with diffusion gradients in all three axes, an isotropic tensor trace pulse DWI sequence and SE MRI were used.
In all patients both DWI sequences showed a decrease in the apparent diffusion coefficient (ADC) in the acute stage, even
when SE images did not reveal signal abnormalities. Clinical features correlated with lesion site but not size. The ADC was
initially 19.6–43 % less than that of nonischaemic tissue and increased to normal after 7 days in conventionally treated patients
and after 2–5 days in patients who underwent intra-arterial fibrinolysis. In the chronic stage the ADC rose by up to 254.4
%. In patients who did not undergo fibrinolysis DWI changes correlated with the final infarct size (P < 0.05). It was possible to differentiate acute from chronic ischaemic lesions. We conclude that DWI is a sensitive and practicable
tool for detecting early cerebral ischaemia. It is possible to predict in the acute stage the final size of an infarct. DWI
may be helpful for clinical decisions and for monitoring therapy.
Received: 1 March 1999/Accepted: 13 July 1999 |
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Keywords: | Ischaemic stroke Diffusion weighted imaging Fibrinolysis |
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