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Volume 4 No. 1, January 2009 |
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Value of Perfusion and
Diffusion MRI in Hyper-Acute Stroke
Department of Radiology(1)
& Neuropsychiatric(2), Faculty of Medicine, Tanta
University, Egypt
Aim: The aim of this study is to assess the value of functional
magnetic resonance imaging in hyper-acute ischemic stroke and the
best way of evaluation of any progressive process in post stroke
period. Patients & Methods: 15 patients with hyperacute ischemic
cerebrovascular stroke were enrolled in this study (10 males and 5
females), with their ages ranged from 23 years to 80 years with a
mean age of 51.5 years. Inclusion criteria were the clinical
presentation with symptoms and signs suggestive of hyperacute
ischemic cerebrovascular stroke. The onset of symptoms was
calculated from the last time the patient was normal (by their
relatives). Results: Diffusion-weighted MRI provides a good estimate
of the infarcted core in early cerebral ischemia. Perfusion-weighted
MRI gives insight into the hemodynamic alterations during cerebral
ischemia. The diffusion/perfusion mismatch (in cases when the
perfusion defect is larger than the diffusion lesion) gives an
estimate of the ischemic penumbra, which is salvageable by a proper
intervention as thrombolysis. During the 1st hours of stroke
evaluation, regions with abnormal perfusion as assessed with PWI,
are typically larger than DWI lesions and this occurs if the
occlusion involving the distribution of large arterial supply, on
the other hand, if the occlusion occurs in distribution of small
perforators the regions with abnormal perfusion will be smaller than
the DWI lesions.Conclusion: The diffusion/perfusion mismatch (in
cases when the perfusion defect is larger than the diffusion lesion)
gives an estimate of the ischemic penumbra, which is salvageable by
a proper intervention as thrombolysis. |
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