Stroke diffusion weighted images

Warach S, Chien D, Li W, Ronthal M, Edelman RR. Fast magnetic resonance diffusion-weighted imaging of acute human stroke. Neurology 1992 42 1717-1723. 

Busza AL, Allen KL, King MD, van Bruggen N, Williams SR, Gadian DG (1992) Diffusion-weighted imaging studies of cerebral ischemia in gerbils potential relevance to energy failure. Stroke 23 1602-1612... 

Strong AJ, Fabricius M, Boutelle MG, Hibbins SJ, Hopwood SE, Jones R, Parkin MC, Lauritzen M (2002) Spreading and synchronous depressions of cortical activity in acutely injured human brain. Stroke 33 2738-2743 Szafer A, Zhong J, Anderson AW, Gore JC (1995) Diffusion-weighted imaging in tissues theoretical models. NMR Biomed 8 289-296... 

Huisman TA (2003) Diffusion-weighted imaging basic concepts and application in cerebral stroke and head trauma. Eur Radiol 13 2283-2297... 

Barber PA, Darby DG, Desmond PM, Gerraty RP, Yang Q, Li T, Jolley D, Donnan GA, Tress BM, Davis SM (1999) Identification of major ischemic change. Diffusion-weighted imaging versus computed tomography. Stroke 30 2059-2065... 

Fig. 11.3. Spectroscopic imaging of stroke. Data from a 71-year-old male were obtained at 3 T using conventional CSI with 144 ms echo time (17 min acquisition time). Metabolite intensities are plotted as color-coded overlay on diffusion-weighted images. Intensities of SI maps of NAA and lactate were obtained by time domain data fit using jMRUI. Representative spectra and fit results (red line) are shown in the lower part of the figure. The arrows indicate the position of the respective voxels. Low Lac values and persistent NAA signals in the posterior part of the area with increased signal on the DWI image may be caused by early reperfusion of an M3 branch of the middle cerebral artery and consecutive washout of Lac...

Fig. 11.4. Fast spectroscopic imaging of stroke. SI maps of lactate and NAA. Metabolite intensities are plotted as color-coded overlay on diffusion-weighted images. Intensities were obtained by numerical integration of the peak areas defined in the two spectra below. Data were acquired with the multiple spin echo SI sequence (7 min acquisition time), thus signal resolution is considerably reduced compared to single voxel spectra in Fig. 11.2 or conventional CSI in Fig. 11.3. (Data courtesy of A. Stengel)...

Ovbiagele B, Kidwell CS, Saver JL (2003) Epidemiological impact in the United States of a tissue-based definition of transient ischemic attack. Stroke 34 919-924 Phillips MD, McGraw P, Lowe MJ, Mathews VP, Hainline BE (2001) Diffusion-weighted imaging of white matter abnormalities in patients with phenylketonuria. Am J Neurora-diol 22 1583-1586... 

Purroy F, Montaner J, Rovira A et al (2004) Higher risk of further vascular events among transient ischemic attack patients with diffusion-weighted imaging acute ischemic lesions. Stroke 35 2313-2319. 

Kang DW, Chalela JA, Ezzeddine MA et al (2003a) Association of ischemic lesion patterns on early diffusion-weighted imaging with TOAST stroke subtypes. Arch Neurol 60 1730-1734... 

Roh JK, Kang DW, Lee SH et al (2000) Significance of acute multiple brain infarction on diffusion-weighted imaging. Stroke 31 688-694... 

Fig 15.1. Diffusion-weighted imaging demonstrates different patterns of acute stroke in occlusive internal carotid artery disease 1, territorial stroke 2, subcortical stroke 3, territorial stroke with fragmentation 4, disseminated small lesions 5, borderzone infarction... 

Ay H, Oliveira-Filho J, Buonanno FS, Ezzeddine M, Schaefer PW, Rordorf G, Schwamm LF[, Gonzalez RG, Koroshetz WJ (1999b) Diffusion-weighted imaging identifies a subset of lacunar infarction associated with embolic source. Stroke 30 2644-2650... 

Fig. 10.3. Images with T2-weighted (a) and diffusion-weighted (b) MRI in a 70-year-old man who presented with a history of sudden-onset numbness and tingling in the left face arm and leg. On examination there was sensory loss over the left hand but nothing else. The diffusion-weighted images confirm a thalamic infarct consistent with the clinical diagnosis of pure sensory stroke.

Redgrave JN, Coutts SB, Schulz UG etal. (2007). Systematic review of associations between the presence of acute ischemic lesions on diffusion-weighted imaging and clinical predictors of early stroke risk after transient ischemic attack. Stroke 38 1482-1488 Rolak LA, Gilmer W, Strittmatter WJ (1990). Low yield in the diagnostic evaluation of transient ischemic attacks. Neurology 40 747-748... 

Schaefer PW, Copen WA, Lev MH et al. (2005). Diffusion-weighted imaging in acute stroke. Neuroimaging Clinics of North American 15 503-530... 

Wen HM, Lam WW, Rainer T et al (2004). Multiple acute cerebral infarcts on diffusion-weighted imaging and risk of recurrent stroke. Neurology 63 1317-1319 Werring DJ, Coward LJ, Losseff NA et al (2005). Cerebral microbleeds are common in ischemic stroke but rare in TTA. Neurology 65 1914-1918... 

Fig. 11.6. A patient with acute ischemic stroke where MRI shows a perfusion-diffusion mismatch with a relatively small area of high signal on diffusion-weighted imaging (a) but a large area of reduced perfusion on perfusion weighted imaging (b).

Lesion patterns and stroke mechanism in atherosclerotic middle cerebral artery disease early diffusion-weighted imaging study. Stroke 36 2583-2588 Lee SH, Bae HJ, Kwon SJ et al. (2004). 

Is impaired cerebral vasomotor reactivity a predictive factor of stroke in asymptomatic patients Stroke 27 2188-2190 HaUiday A, Mansfield A, Marro JC for the MRC Asymptomatic Carotid Surgery Trial (ACST) Collaborative Group (2004). Prevention of disabling and fatal strokes by successful carotid endarterectomy in patients without recent neurological symptoms randomised controlled trial Lancet 363 1491-1502 Hand PJ, Wardlaw JM, Rivers CS et al. (2006). MR diffusion-weighted imaging and outcome prediction after ischemic stroke. Neurology 66 1159-1163... 

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