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Radiology, Vol 199, 403-408, Copyright © 1996 by Radiological Society of North America

ARTICLES

Acute and chronic stroke: navigated spin-echo diffusion-weighted MR imaging [published erratum appears in Radiology 1996 Jul;200(1):289]

MP Marks, A de Crespigny, D Lentz, DR Enzmann, GW Albers and ME Moseley
Department of Radiology, Stanford University Medical Center, Stanford, CA 94305-5105, USA.

PURPOSE: The authors evaluated a phase-navigated spin-echo (SE) motion- correction sequence for use at diffusion-weighted (DW) magnetic resonance (MR) imaging after cerebral infarction. MATERIALS AND METHODS: Twenty-nine patients underwent 32 conventional T2-weighted fast SE and SE DW imaging after stroke (n=25), transient ischemic attack (n=3), or reversible ischemic neurologic deficit (n=1). Imaging was performed in a standard head holder with standard padding. Apparent diffusion coefficient (ADC) maps were constructed. RESULTS: DW images depicted high signal intensity compatible with localization of the ischemic symptoms in all cases. Lesions were depicted more clearly on DW than on T2-weighted images. On DW images, acute infarct ADC values were uniformly low (mean, 0.401x10(-5) cm2/sec =+/- 0.143 [standard deviation]) compared with control ADC values (mean, 0.754x10(-5) cm2/sec +/- 0.201). ADC values of chronic infarcts were supranormal (mean, 1.591x10(-5) cm2/sec +/- 0.840) compared with control values (mean, 0.788x10(-5) cm2/sec +/- 0.166). DW imaging did not show a change after transient ischemic attack. with reversible ischemic neurologic deficit, however, hyperintensity on DW images and low ADC resolved after symptoms abated. CONCLUSION: Clinical phase-navigated SE DW imaging improved early diagnosis of stroke and helped differentiate acute from chronic stroke. Changes on DW images are reversed after symptoms resolve.


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