Document Detail

Evolution of the diffusion-weighted signal and the apparent diffusion coefficient in the late phase after minor stroke: a follow-up study.
MedLine Citation:
PMID:  17345037     Owner:  NLM     Status:  MEDLINE    
INTRODUCTION: Diffusion-weighted imaging (DWI) is mainly used in acute stroke, and signal evolution in the acute phase has been studied extensively. However, patients with a minor stroke frequently present late. Recent studies suggest that DWI may be helpful at this stage, but only very few published data exist on the evolution of the DW-signal in the weeks and months after a stroke. We performed a follow-up study of DWI in the late stages after a minor stroke. METHODS: 28 patients who presented 48 hours to 14 days after a minor stroke underwent serial MRI at baseline, 4 weeks, 8 weeks, 12 weeks, 6 months and>or=9 months after their event. Signal intensity within the lesion was determined on T2-weighted images, DW-images and the Apparent Diffusion Coefficient (ADC) map at each time-point, and ratios were calculated with contralateral normal values (T2r, DWIr, ADCr). RESULTS: T2r was increased in all patients from the beginning, and showed no clear temporal evolution. ADCr normalized within 8 weeks in 83% of patients, but still continued to increase for up to 6 months after the event. The DW-signal decreased over time, but was still elevated in 6 patients after>or=6 months. The evolution of ADCr and DWIr showed statistically highly significant inter-individual variation (p<0.0001), which was not accounted for by age, sex, infarct size or infarct location. CONCLUSION: The ADC and the DW-signal may continue to evolve for several months after a minor ischaemic stroke. Signal evolution is highly variable between individuals. Further studies are required to determine which factors influence the evolution of the ADC and the DW-signal.
U G R Schulz; E Flossmann; J M Francis; J N Redgrave; P M Rothwell
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2007-03-07
Journal Detail:
Title:  Journal of neurology     Volume:  254     ISSN:  0340-5354     ISO Abbreviation:  J. Neurol.     Publication Date:  2007 Mar 
Date Detail:
Created Date:  2007-03-12     Completed Date:  2007-07-06     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0423161     Medline TA:  J Neurol     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  375-83     Citation Subset:  IM    
Department of Clinical Stroke Prevention Research Unit, University of Neurology, Radcliffe Infirmary, and Centre for Clinical Magnetic Resonance Research, John Radcliffe Hospital, Oxford, OX2 6HE, United Kingdom.
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MeSH Terms
Aged, 80 and over
Brain Mapping*
Diffusion Magnetic Resonance Imaging*
Disease Progression
Echo-Planar Imaging*
Follow-Up Studies
Image Processing, Computer-Assisted / methods
Middle Aged
Stroke / diagnosis*
Time Factors
Grant Support
//Wellcome Trust

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