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AJNR - American Journal of Neuroradiology

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Value of Diffusion-Weighted Imaging and Apparent Diffusion Coefficient in Recent Cerebral Infarctions: A Correlative Study with Contrast-Enhanced T1-Weighted Imaging

Naoaki Yamada^,a, Satoshi Imakita^a and Toshiharu Sakuma^a

^a From the Department of Radiology, National Cardiovascular Center, 5-7-1, Fujishiro-dai, Suita, Osaka 565-8565, Japan.

View larger version (11K): [in a new window]   FIG 1. ADC as a function of time after stroke onset. Both embolic and thrombotic infarcts have a low ADC before 6 days, but they vary in the subacute phase (6 27 days). An extremely high ADC is observed in three embolic infarcts in the early subacute phase (6 10 days)

View larger version (116K): [in a new window]   FIG 2. A–D, Embolic infarcts at 3 days (right frontal) and 6 days (left frontal) after stroke onset. Right frontal infarct reveals marked high intensity on the diffusion-weighted image (A), and a low ADC (B) and little enhancement (C, before contrast; D, after contrast) on the T1-weighted SE images. Black rectangle indicates the ROI placed in the core region (A). Anterior portion of left frontal infarct reveals a mild high-intensity signal on the diffusion-weighted image (A) and a moderately high ADC (B) and marked enhancement (C and D) on the T1-weighted SE images. The posterior portion has extremely low intensity on the diffusion-weighted image because of hemorrhage (arrow in A). White rectangle (A) indicates the ROI placed in the anterior portion.

View larger version (116K): [in a new window]   FIG 3. Thrombotic infarct of the right corona radiata (27 days after stroke onset) has marked high intensity on the diffusion-weighted image (A) and a low ADC (B) and little enhancement (C and D) on the T1-weighted SE images. Black rectangle shows the ROI placed in the core region (A)

View larger version (9K): [in a new window]   FIG 4. CER on T1-weighted SE images is low in the acute phase (<6 days), but varies in the subacute phase (6 to 27 days). An extremely high CER is observed in three embolic infarcts in the early subacute phase (6 to 10 days)

View larger version (11K): [in a new window]   FIG 5. ADC is linearly correlated with contrast enhancement on T1-weighted SE images (CER) in both thrombotic and embolic infarcts. Correlation coefficients are 0.85 for thrombotic and 0.82 for embolic infarcts

View larger version (12K): [in a new window]   FIG 6. Contrast enhancement on T1-weighted SE images (CER) is inversely correlated with relative signal intensity (RSI) on diffusion-weighted images. All the infarcts reveal higher values than normal brain tissue with either the CER or relative signal intensity