Early Ischemic Stroke: Comparison of Diffusion Weighted Images and ADC maps.
10.3348/jkrs.1998.39.1.21
- Author:
Soo Jung CHOI
1
;
Choong Gon CHOI
;
Jae Kyun KIM
;
Jung Hoon KIM
;
Jae Hong LEE
;
Ho Kyu LEE
;
Dae Chul SUH
;
Jong Sung KIM
Author Information
1. Department of Radiology, University of Ulsan, College of Medicine Asan Medical Center, Korea.
- Publication Type:Original Article
- Keywords:
Brain, MR;
Brain, infarction
- MeSH:
Diffusion*;
Humans;
Retrospective Studies;
Stroke*
- From:Journal of the Korean Radiological Society
1998;39(1):21-27
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: The purpose of this study was to compare the clinical utility of diffusion-weighted images(DWI) withthat of apparent diffusion coefficient(ADC) maps for detecting early ishemic strokes. MATERIALS AND METHODS: In22 patients with infarct, lesion conspicuity as seen on T2-weighted images(T2WI), low diffusion-weightedimages(DWI ; b value 300 sec/mm2), high DWI(b value 1000 sec/mm2), and ADC maps was retrospectively compared. Theinfarct was hyperacute (< 6 hours) in six, acute (< 48 hours) in six, and subacute (< 2 weeks) in ten. All imageswere obtained using an echo-planar spin echo sequence; lesion conspicuity was graded from 0 to 2 by tworadiologists. Signal intensity was analysed in 17 patients[hyperacute (n=5); acute (n=4); and subacute (n=8)].Lesion-to-controlateral normal side signal intensity ratio(SIR) and contrast-to-noise ratio(CNR) were measured andcompared between four different types of images. RESULT: With regard to lesion conspicuity, high DWI wassuperior to the other images for detecting hyperacute strokes(Grade 2, 6/6). In such cases, an ADC map showedgrade 0 lesion conspicuity in one case, grade 1 in three, and grade 2 in two. There was no significant differencein lesion conspicuity in acute and subacute strokes between DWI(low & high) and T2WI(Grade 2, 16 in each). An ADCmap in acute and subacute stroke showed Grade 1 in four cases and Grade 2 in 12. Signal intensity analysis of SIRand CNR showed that high DWI was also superior to the other images for detecting hyperacute ischemic strokes(p <0.05, n=5), and superior to an ADC map in acute and subacute stroke(p < 0.05, n=12). CONCLUSION: Diffusion-weighted images with a high b value could be more useful than ADC maps and conventional T2-weightedimages, especially for the detection of hyperacute strokes.
