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Use of exponential diffusion imaging to determine the age of ischemic infarcts.

Publication ,  Journal Article
Engelter, ST; Provenzale, JM; Petrella, JR; Alberts, MJ; DeLong, DM; MacFall, JR
Published in: J Neuroimaging
April 2001

Diffusion-weighted magnetic resonance imaging (DWI) detects acute ischemic infarcts with high lesion conspicuity. Determination of infarct age is difficult on DWI alone because infarct signal intensity (SIinfarct) on DWI is influenced by T2 properties ("T2 shine-through"). Maps of the apparent diffusion coefficient (ADC) reflect pure diffusion characteristics without T2 effects but have low lesion conspicuity. Thus, in clinical practice, combined use of DWI and ADC maps is required. Exponential DWI (eDWI) is an innovative means of MRI-diffusion data analysis that merges the advantages of DWI and ADC maps. The authors hypothesized that SIinfarct on eDWI would correlate with infarct age. The authors studied 114 consecutive patients who had 120 ischemic strokes with clearly determined onset times and who underwent echo-planar DWI. The eDWI were generated by dividing the signal intensity on DWI by that on the corresponding T2 image on a pixel-by-pixel basis. SIinfarct on eDWI was measured in the lesion core and expressed as a percentage of contralateral control tissue. On eDWI, relative SIinfarct changed significantly with infarct age (P < .0001). When patients were sorted in infarct-age groups, no significant differences were found within the first 120 hours. However, for patients studied within 5 days, the mean relative SIinfarct was significantly higher compared with patients studied > or = 8 days after stroke (P < .05). For all infarcts up to 5 days old, the eDWI signal intensity was higher than control tissue (hyperintense appearance). All infarcts > 10 days old had an eDWI signal intensity lower than control tissue (hypointense appearance). The authors concluded that the use of eDWI, as a single set of images, reliably differentiates acute infarcts (< or = 5 days old) from infarcts > 10 days old. This feature would be expected to be helpful when the distinction between acute and nonacute infarction cannot be determined on clinical grounds.

Duke Scholars

Published In

J Neuroimaging

DOI

ISSN

1051-2284

Publication Date

April 2001

Volume

11

Issue

2

Start / End Page

141 / 147

Location

United States

Related Subject Headings

  • Sensitivity and Specificity
  • Neurology & Neurosurgery
  • Middle Aged
  • Male
  • Magnetic Resonance Imaging
  • Image Processing, Computer-Assisted
  • Image Enhancement
  • Humans
  • Female
  • Diffusion
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Engelter, S. T., Provenzale, J. M., Petrella, J. R., Alberts, M. J., DeLong, D. M., & MacFall, J. R. (2001). Use of exponential diffusion imaging to determine the age of ischemic infarcts. J Neuroimaging, 11(2), 141–147. https://doi.org/10.1111/j.1552-6569.2001.tb00024.x
Engelter, S. T., J. M. Provenzale, J. R. Petrella, M. J. Alberts, D. M. DeLong, and J. R. MacFall. “Use of exponential diffusion imaging to determine the age of ischemic infarcts.J Neuroimaging 11, no. 2 (April 2001): 141–47. https://doi.org/10.1111/j.1552-6569.2001.tb00024.x.
Engelter ST, Provenzale JM, Petrella JR, Alberts MJ, DeLong DM, MacFall JR. Use of exponential diffusion imaging to determine the age of ischemic infarcts. J Neuroimaging. 2001 Apr;11(2):141–7.
Engelter, S. T., et al. “Use of exponential diffusion imaging to determine the age of ischemic infarcts.J Neuroimaging, vol. 11, no. 2, Apr. 2001, pp. 141–47. Pubmed, doi:10.1111/j.1552-6569.2001.tb00024.x.
Engelter ST, Provenzale JM, Petrella JR, Alberts MJ, DeLong DM, MacFall JR. Use of exponential diffusion imaging to determine the age of ischemic infarcts. J Neuroimaging. 2001 Apr;11(2):141–147.
Journal cover image

Published In

J Neuroimaging

DOI

ISSN

1051-2284

Publication Date

April 2001

Volume

11

Issue

2

Start / End Page

141 / 147

Location

United States

Related Subject Headings

  • Sensitivity and Specificity
  • Neurology & Neurosurgery
  • Middle Aged
  • Male
  • Magnetic Resonance Imaging
  • Image Processing, Computer-Assisted
  • Image Enhancement
  • Humans
  • Female
  • Diffusion