Persistent high signal on diffusion-weighted MRI in the late stages of small cortical and lacunar ischaemic lesions

Neuroradiology
B GeijerS Holtås

Abstract

Diffusion-weighted imaging (DWI) is very sensitive to early brain infarcts. However, the late stages have been insufficiently studied. Infarcts in small vessel disease are often multiple and of different ages, and differentiation between new and old lesions might be difficult. We have therefore studied the change with time in DWI of small (< 3 ml) ischaemic lesions. We imaged 21 patients with an acute lacunar syndrome and a lesion visible on early DWI. They all had three MRI examinations 12-58 h (early), 7-16 and 54-144 days after the onset of stroke; 10 patients with high DWI signal on the third examination had a fourth examination 12-28 months after the stroke. MRI was performed at 1.5 T, using echo-planar DWI with 7 b-values from 0 to 1200 x 10(6) s/m2 and conventional T2-weighted imaging. After 7-16 days 18 of 21 lesions gave high signal on DWI, and 12/16 measurable lesions had a decreased apparent diffusion coefficient (ADC). After 54-144 days ten lesions still gave high DWI signal and two still had an ADC below normal. On the fourth examination there was no remaining high DWI signal and all ADC were higher than normal.

Citations

Dec 20, 2005·Expert Review of Medical Devices·Eric JüttlerPeter D Schellinger
Jan 1, 2008·Journal of the Neurological Sciences·Xin WangKa Sing Wong
Jul 1, 2006·Journal of Neuroimaging : Official Journal of the American Society of Neuroimaging·Xin WangKa Sing Wong
Apr 9, 2013·Journal of Magnetic Resonance Imaging : JMRI·Jean-Pierre LaissyJean-Michel Serfaty
Jun 9, 2004·Seminars in Vascular Surgery·Manzoor Ahmed, Thomas J Masaryk
Dec 1, 2010·The Neuroradiology Journal·F TortoraS Cirillo
Sep 18, 2004·Stroke; a Journal of Cerebral Circulation·Ursula G SchulzPeter M Rothwell

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