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AJNR - American Journal of Neuroradiology

Published ahead of print on April 3, 2009
doi: 10.3174/ajnr.A1537

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Acute Ischemic Infarction Defined by a Region of Multiple Hypointense Vessels on Gradient-Echo T2* MR Imaging at 3T

D. Kaya^a, A. Dinçer^b, M.E. Yildiz^b, M.O. Çizmeli^b and C. Erzen^b

^a Departments of Neurology, Acibadem University School of Medicine, Istanbul, Turkey
^b Radiology, Acibadem University School of Medicine, Istanbul, Turkey

View larger version (134K): [in this window] [in a new window]   Fig 1. A, Craniocaudal collapsed MIP image of 3D TOF-MRA shows right MCA occlusion in case 2. B, Axial DWI-b2000 trace image shows hyperintensity in corresponding ischemic territory, C, Axial GRE-T2* shows RMHV as linear or branching structures strictly in the ischemic territory. Please note that the contralateral hemisphere is free of such structures. D, Axial GRE-T2* shows outlined RMHV on the same image. TTP (E), rCBF (F), and rCBV (G) maps show hypoperfusion area in corresponding ischemic territory.

View larger version (59K): [in this window] [in a new window]   Fig 2. Right ICA occlusion in case 15. A, DWI-b2000 image shows small hyperintensities in the right posterior temporal and anterior parietal lobes, the caudate body and head, the right putamen and globus pallidus, and the internal and external capsules. B, Axial GRE-T2* corresponding image shows large hemispheric RMHV in the ischemic territory. C, Follow-up CT image shows the infarcted area at 72 hours.

View larger version (13K): [in this window] [in a new window]   Fig 3. A, Baseline DWI, RMHV on GRE-T2*, TTP, MTT, rCBF, rCBV, and the infarct volume at 72 hours on follow-up images in group 1. There is no significant difference of volumes among TTP, MTT, rCBF, and RMHV on GRE-T2* and the infarct volume at 72 hours. B, Baseline DWI, RMHV on GRE-T2*, and the infarct volume at 72 hours on follow-up images in group 2. There is no significant difference of volumes between RMHV on GRE-T2* and the infarct volume at 72 hours. C, Volumetric measurement of lesions on baseline DWI, RMHV on GRE-T2*, TTP, MTT, rCBF, and rCBV in group 3. There is no significant difference of volumes among TTP, MTT, rCBF, and RMHV on GRE-T2*.

View larger version (18K): [in this window] [in a new window]   Fig 4. Bland Altman plot of differences between 2 examiners. Dashed lines represent the mean (1.6 mL) and upper and lower boundaries. A total of 100% of data points are within the boundary limits for RMHV on GRE-T2*.