Does the ADC Map have Additional Clinical Significance Compared to the DWI in the Brain Infarction?
2
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
Purpose : To re-evaluate additional clinical significance of the apparent diffusion coefficient (ADC) map in the inference of infarction stage, authors studied the evolution patterns of the DWI and the ADC map of the brain infarction. Materials and Methods: In 127 patients with cerebral infarctions, including follow-up checks, 199 studies were performed. They were classified as hourly (117 studies)-, daily (108 studies)-, weekly (62 studies)-based groups. The signal intensity (SI) was measured at the core of the infarction and contralateral area with ROI of 0.3 cm2 or more on the images of the DWI and the ADC map, and calculated the ratios of SI and ADC value of the infarction area / contralateral normal area, and compared the patterns of the change according to the evolution. Results: Infarction was detected as early as 1 hour after the attack, and the ratio of SI in the DWI became over than 2after 12 hours, which showed a plateau until the 6th day. Thereafter, it decreased slowly to 1 on the 30th day, and changed to lower SI than the surrounding brain. The ratio in the ADC map became 0.46 in 24 hours after the attack, and increased slowly to 1 in the 15th day. Thereafter, it became a higher value than the surrounding brain. Overall, the ratio in the ADC map changed earlier than in the DWI, and the ratio curves showed inverse pattern each other according to the evolution of the infarction. Conclusion: The evolution patterns of infarction on the ADC map showed an inverse curve of DWI curve, which means that the ADC value is accurately predictable from DWI, and the ADC map joined with the DWI seems helpful in the determination of subacute infarction between 15 to 30 days.
Abstract
Purpose : To re-evaluate additional clinical significance of the apparent diffusion coefficient (ADC) map in the inference of infarction stage, authors studied the evolution patterns of the DWI and the ADC map of the brain infarction. Materials and Methods: In 127 patients with cerebral infarctions, including follow-up checks, 199 studies were performed. They were classified as hourly (117 studies)-, daily (108 studies)-, weekly (62 studies)-based groups. The signal intensity (SI) was measured at the core of the infarction and contralateral area with ROI of 0.3 cm2 or more on the images of the DWI and the ADC map, and calculated the ratios of SI and ADC value of the infarction area / contralateral normal area, and compared the patterns of the change according to the evolution. Results: Infarction was detected as early as 1 hour after the attack, and the ratio of SI in the DWI became over than 2after 12 hours, which showed a plateau until the 6th day. Thereafter, it decreased slowly to 1 on the 30th day, and changed to lower SI than the surrounding brain. The ratio in the ADC map became 0.46 in 24 hours after the attack, and increased slowly to 1 in the 15th day. Thereafter, it became a higher value than the surrounding brain. Overall, the ratio in the ADC map changed earlier than in the DWI, and the ratio curves showed inverse pattern each other according to the evolution of the infarction. Conclusion: The evolution patterns of infarction on the ADC map showed an inverse curve of DWI curve, which means that the ADC value is accurately predictable from DWI, and the ADC map joined with the DWI seems helpful in the determination of subacute infarction between 15 to 30 days.
참고문헌 (13)
- van Everdingen KJ, "Diffusion-weighted magnetic resonance imaging in acute stroke", Stroke, 29, pp.1783~1790 (1998)
- Lansberg MG, "Evolution of apparent diffusion coefficient, diffusion-weighted, and T2- weighted signal intensity of acute stroke", AJNR Am J Neuroradiol, 22, pp.637~644 (2001)
- Barajas RF, "Diffusion-weighted MR imaging derived apparent diffusion coefficient is predictive of clinical outcome in primary central nervous system lymphoma", AJNR Am J Neuroradiol, 131, pp.60~66 (2010)
- Desmond PM, "The value of apparent diffusion coefficient maps in early cerebral ischemia", AJNR Am J Neuroradiol, 22, pp.1260~1267 (2001)
- Rana AK, "Apparent diffusion coefficient (ADC) measurements may be more reliable and reproducible than lesion volume on diffusion-weighted images from patients with acute ischemic stroke; implications for study design", J Magn Reson Imaging, 21, pp.617~624 (2003)
- Bratane BT, "Ischemic lesion volume determination on diffusion weighted images vs. apparent diffusion coefficient maps", Brain Research, 1279, pp.182~188 (2009)
- Oppenheim C, "Is there an apparent diffusion coefficient threshold in predicting tissue viability in hyperacute stroke?", Stroke, 32, pp.2486~2491 (2001)
- Sibon I, "Inter- and intraobserver reliability of five MRI sequences in the evaluation of the final volume of cerebral infarct", J Magn Reson Imaging, 29, pp.1280~1284 (2009)
- Na DK, "Diffusion-weighted MR imaging in acute ischemia: Value of apparent diffusion coefficient and signal intensity thresholds in predicting tissue at risk and final infarct size.", AJNR Am J Neuroradiol, 25, pp.1331~1336 (2004)
- Eastwood JD, "Quantitative assessment of the time course of infarct signal intensity on diffusion-weighted images", AJNR Am J Neuroradiol, 24, pp.680~687 (2003)
- Yang Q, "Serial study of apparent diffusion coefficient and anisotropy in patients with acute stroke", Stroke, 30, pp.2382~2390 (1999)
- Copen WA, "Ischemic stroke: effects of etiology and patient age on the time course of the core apparent diffusion coefficient", Neuroradiology, 221, pp.27~34 (2001)
- Burdette JH, "Cerebral infarction: time course of signal intensity changes on diffusion-weighted MR images", AJR Am J Roentgenol, 171, pp.791~795 (1998)