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Diffusion-weighted MRI in cortical ischaemia

  • Diagnostic Neuroradiology
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Abstract

We carried out MRI on 16 male and three female comatose patients, aged 2 days to 79 years, with suspected cortical ischaemia referred from our intensive care units. Using a head coil, and following standard imaging, including coronal fluid-attenuated inversion-recovery images, we performed diffusion-weighted imaging (DWI) using a whole-brain multislice single-shot echo-planar sequence with b 0 and 1000 s/mm2: 5-mm slices covering the whole brain, TR 7000 TE 106 ms, 128×128 pixels, field of view 250 mm, one excitation. Maps of apparent diffusion coefficients (ADC) were generated automatically. DWI showed cortical, basal ganglia and watershed-area high signal in all cases, associated with a decrease in ADC to 60– 80% of normal. DWI showed lesions not seen (40%) or underestimated (40%) on conventional T2-weighted imaging. Within 24 h of the onset of symptoms, DWI showed changes not readily detectable on T2-weighted images. The cortical high signal on DWI and the ADC changes, suggesting severe ischaemia rather than oedema, was found in areas known to be affected by cortical laminar necrosis. Extension to the brain stem and white matter was associated with a higher likelihood of death.

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Acknowledgements

This work was supported by grant 3100-06634 from the Swiss National Science Foundation.

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Authors and Affiliations

  1. Unité de Neuroradiologie, Service de Radiodiagnostic, DRRI, Hôpital Cantonal Un iversitaire de Genève , 24 rue Micheli-du-Crest, 1211, Geneva 14, Switzerland

    K. O. Lövblad, S. G. Wetzel, T. Somon, K. Wilhelm, A. Mehdizade, A Kelekis, F. Lazeyras, F. Terrier, D. Rüfenacht & J. Delavelle

  2. Department of Neurology, Hôpital Cantonal Universitaire de Genève, 24 rue Micheli-du-Crest, 1211, Geneva 14, Switzerland

    S. Perrig & R. Sztajzel

  3. Department of Neuroradiology, University of Bern, Switzerland

    M. El-Koussy, M. Bishof & G. Schroth

  4. Department of Diagnostic Radiology, Cairo University, Cairo, Egypt

    M. El-Koussy & S. El-Tatawy

Authors
  1. K. O. Lövblad
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  2. S. G. Wetzel
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  3. T. Somon
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  4. K. Wilhelm
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  5. A. Mehdizade
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  6. A Kelekis
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  7. M. El-Koussy
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  8. S. El-Tatawy
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  9. M. Bishof
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  10. G. Schroth
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  11. S. Perrig
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  12. F. Lazeyras
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  13. R. Sztajzel
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  14. F. Terrier
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  15. D. Rüfenacht
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  16. J. Delavelle
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Corresponding author

Correspondence to K. O. Lövblad.

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Lövblad, K.O., Wetzel, S.G., Somon, T. et al. Diffusion-weighted MRI in cortical ischaemia. Neuroradiology 46, 175–182 (2004). https://doi.org/10.1007/s00234-003-1133-7

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  • DOI: https://doi.org/10.1007/s00234-003-1133-7

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