Persistent infarct hyperintensity on diffusion-weighted imaging late after stroke indicates heterogeneous, delayed, infarct evolution

Stroke; a Journal of Cerebral Circulation
C S RiversM S Dennis

Abstract

Some infarcts have persistently hyperintense areas on diffusion-weighted MRI (DWI) even at 1 month after stroke, whereas others have become isointense to normal brain. We hypothesized that late DWI hyperintensity reflected different infarct evolution compared with areas that were isointense by 1 month. We recruited patients prospectively with ischemic stroke, performed DWI and perfusion-weighted MRI (PWI) on admission, at 5 days, 14 days, and 1 month after stroke, and assessed functional outcome at 3 months (Rankin Scale). Patient characteristics and DWI/PWI values were compared for patients with or without "still hyperintense" infarct areas on 1-month DWI. Among 42 patients, 27 (64%) had "still hyperintense" infarct regions at 1 month, mostly in white matter. Patients with "still hyperintense" regions at 1 month had lower baseline apparent diffusion coefficient ratio (ADCr; mean+/-SD 0.76+/-0.12 versus 0.85+/-0.12; hyperintense versus isointense; P<0.05), prolonged reduction of ADCr (repeated-measures ANOVA; P<0.01), no difference in baseline perfusion but delayed normalization of mean transit time (P<0.05) and cerebral blood flow ratios (repeated measures ANOVA; P<0.05), initially more severe stroke, and worse 3-month outcome...Continue Reading

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Citations

Jan 16, 2010·Medical & Biological Engineering & Computing·David N KennedyVerne S Caviness
Mar 6, 2012·Translational Stroke Research·Loren E GloverCesar V Borlongan
Nov 8, 2012·PloS One·Magdalena ChechlaczGlyn W Humphreys
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Jun 29, 2012·Journal of Cerebral Blood Flow and Metabolism : Official Journal of the International Society of Cerebral Blood Flow and Metabolism·Kate Lykke LambertsenBente Finsen
May 28, 2009·Journal of Magnetic Resonance Imaging : JMRI·Igor SibonVincent Dousset
Oct 1, 2010·Journal of Magnetic Resonance Imaging : JMRI·Rüdiger J Seitz, Geoffrey A Donnan
Nov 19, 2013·Magnetic Resonance in Medicine : Official Journal of the Society of Magnetic Resonance in Medicine·Moran ArtziUNKNOWN STIR and VISTA Imaging collaborators
Jul 25, 2012·Computer Methods and Programs in Biomedicine·Fan ZhuJoanna Wardlaw
Nov 30, 2018·Acta Neuropathologica·Kate Lykke LambertsenBettina Hjelm Clausen
Jun 10, 2021·Journal of Neurology, Neurosurgery, and Psychiatry·Kim WiegertjesJoanna M Wardlaw
Aug 17, 2021·Topics in Magnetic Resonance Imaging : TMRI·Varsha MuddasaniMatthew D Alexander

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