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FIG 5. Patient 11, with stroke. Three days after ictus, axial T1-weighted images without (A) and with (B) gadolinium show no significant enhancement in left insular cortex, basal ganglia, and frontoparietal lobe. The corresponding DWI, T2, and fluid-attenuated inversion recovery images showed high intensity (not shown) consistent with acute middle cerebral artery infarction. T1 images obtained 10 days later with ferumoxtran-10 (C) show significant enhancement in the same region. Ninety days later (D), axial T1-weighted image after gadolinium shows no enhancement. It is clear that ferumoxtran-10 enhancement was intense, but because the BBB opening in stroke generally occurs 4–7 days after the ictus, gadolinium may have also enhanced the lesion if the gadolinium scan had been done a few days later.
