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Outcome of Acute Ischemic Lesions Evaluated by Diffusion and Perfusion MR ImagingGo

Toshihiro UedaGo,a, William T. C. Yuha, Joan E. Maleya, Jerome P. Quetsa, Paul Y. Hahna and Vincent A. Magnottaa

a From the Department of Radiology, The University of Iowa Hospitals and Clinics, 200 Hawkins Dr, Iowa City, IA 52242.



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  		FIG 1. Case 1: 61-year-old woman who had imaging 48 hours after the onset of symptoms.

A, T2-weighted MR image shows a high intensity area (arrow) in the right occipital region.

B, The ADC map shows an abnormal occipital lesion (arrowheads), which is much larger than that seen on initial T2-weighted image (A) and follow-up CT scan (E).

C, The rMTT map also shows an abnormal occipital lesion (arrowheads), which is larger than that seen on initial T2-weighted image (A) and follow-up CT scan (E).

D, The rCBV map shows an abnormal occipital lesion (arrow), which is a little larger than that seen on T2-weighted image (A) but almost the same size as that on follow-up CT scan (E).

E, Follow-up CT scan 11 months later shows infarction (arrow) in the right occipital region.



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  		FIG 2. Case 2: 35-year-old woman who had imaging 72 hours after the onset of symptoms.

A, T2-weighted MR image shows bilateral posterior watershed lesions (arrows).

B, The ADC map also shows bilateral posterior watershed lesions (arrowheads), but both lesions are larger than those seen on T2-weighted images.

C, The rMTT map shows mild hypoperfusion extensively at the territories of both posterior cerebral arteries (arrowheads).

D, The rCBV map shows only a left-sided lesion (arrow), including posterior watershed and part of the posterior cerebral artery territory.

E, The 16-month follow-up T2-weighted image confirmed small left posterior watershed infarction (arrow) and another infarction at the territory of the left posterior cerebral artery (arrowhead), which was not apparent on initial T2-weighted image or ADC map but was visible on rCBV map.





Copyright © 2009 by the American Society of Neuroradiology. Print ISSN: 0195-6108 Online ISSN: 1936-959X