American Journal of Neuroradiology 21:1596-1602 (10 2000)
© 2000 American Society of Neuroradiology
ARTICLE
Diffusion-weighted Imaging of Patients with Subacute Cerebral Ischemia: Comparison with Conventional and Contrast-enhanced MR Imaging
a From the Department of Neurology (M.A., R.B., R.S., H-P.H., F.F.) and the MR Institute (M.A., R.B., J.S., R.S., F.F.), Karl-Franzens University, Graz, Austria.
BACKGROUND AND PURPOSE: The importance of diffusion-weighted imaging (DWI) for delineating acute ischemic lesions has been investigated extensively; however, few studies have investigated the role of DWI in the subacute stage of stroke. Because these lesions tend to appear bright throughout the first days of ischemia, owing to restricted diffusion, we speculated that DWI could also improve the detection of subacute infarcts as compared with conventional and contrast-enhanced MR imaging.
METHODS: Interleaved echo-planar DWI with phase navigation was performed on a 1.5-T MR unit in a consecutive series of 53 patients (mean age, 66 ± 14 years) with suspected recent cerebral ischemia. The interval between onset of clinical symptoms and MR imaging ranged from 1 to 14 days (mean, 6 ± 4 days). Contrast material was given to 28 patients in a dose of 0.1 mmol/kg.
RESULTS: DWI clearly delineated recent ischemic damage in 39 patients (74%) as compared with 33 (62%) in whom lesions were identified or suspected on conventional T2-weighted images. DWI provided information not accessible with T2-weighted imaging in 17 patients when evidence of lesion multiplicity or detection of clinically unrelated recent lesions was included for comparison. Subacute ischemic lesions were also seen more frequently on DWI sequences than on contrast-enhanced images (20 versus 13 patients). DWI was more likely to make a diagnostic contribution in the first week of stroke and in patients with small lesions or preexisting ischemic cerebral damage than was conventional MR imaging.
CONCLUSION: Recent ischemic damage is better shown on DWI sequences than on conventional and contrast-enhanced MR images throughout the first days after stroke and may provide further information about the origin of clinical symptoms. Adding DWI to imaging protocols for patients with subacute cerebral ischemia is recommended.
This article has been cited by other articles:
 |
|
 |
|
  T Seifert, C Enzinger, M K Storch, G Pichler, K Niederkorn, and F Fazekas Acute small subcortical infarctions on diffusion weighted MRI: clinical presentation and aetiology J. Neurol. Neurosurg. Psychiatry, November 1, 2005; 76(11): 1520 - 1524. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 C. K. Kuhl, J. Gieseke, M. von Falkenhausen, J. Textor, S. Gernert, C. Sonntag, and H. H. Schild Sensitivity Encoding for Diffusion-weighted MR Imaging at 3.0 T: Intraindividual Comparative Study Radiology, February 1, 2005; 234(2): 517 - 526. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 Y. Inatomi, K. Kimura, T. Yonehara, S. Fujioka, and M. Uchino DWI abnormalities and clinical characteristics in TIA patients Neurology, February 10, 2004; 62(3): 376 - 380. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
W. A. Willinek, J. Gieseke, M. von Falkenhausen, B. Neuen, H. H. Schild, and C. K. Kuhl Sensitivity Encoding for Fast MR Imaging of the Brain in Patients with Stroke Radiology, September 1, 2003; 228(3): 669 - 675. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
U G R Schulz, D Briley, T Meagher, A Molyneux, and P M Rothwell Abnormalities on diffusion weighted magnetic resonance imaging performed several weeks after a minor stroke or transient ischaemic attack J. Neurol. Neurosurg. Psychiatry, June 1, 2003; 74(6): 734 - 738. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 I. Mader, M. Schoning, U. Klose, and W. Kuker Neonatal Cerebral Infarction Diagnosed by Diffusion-Weighted MRI: Pseudonormalization Occurs Early Stroke, April 1, 2002; 33(4): 1142 - 1145. [Abstract] [Full Text] [PDF]
|
|