Time course of cerebral infarction in the middle cerebral arterial territory: Deep watershed versus territorial subtypes on diffusion-weighted MR images

I. J. Huang, C. Y. Chen, H. W. Chung, D. C. Chang, C. C. Lee, S. C. Chin, M. Liou

Research output: Contribution to journalArticle

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Abstract

PURPOSE: To examine possible differences between the evolution of cerebral watershed infarction (WI) and that of territorial thromboembolic infarction (TI) by using diffusion-weighted (DW) and T2-weighted magnetic resonance (MR) images and apparent diffusion coefficient (ADC) maps. MATERIALS AND METHODS: Fourteen patients with TI and nine with WI underwent MR imaging from the acute to chronic infarction stages. ADC maps were derived from DW images. Lesion-to-normal tissue signal intensity ratios on ADC maps (rADC), echo-planar T2-weighted images, and DW images were calculated. Lesion volumes at acute or early subacute infarction stages were measured on DW images, and final lesion volumes were estimated on fluid-attenuated inversion-recovery images. RESULTS: Analysis of variance revealed a significant difference in temporal evolution patterns of rADC between WI and TI (P <.001). rADC pseudonormalization following TI began about 10 days after symptom onset, but that following WI did not occur until about 1 month after symptom onset. The Pearson correlation coefficient between final and initial infarct volumes was 0.9899 for both infarction subtypes, indicating that the initial ischemic injury volume measured at the acute or early subacute stage predicted the final lesion volume fairly well. CONCLUSION: The evolution time of ADC is faster for TI than for WI. This difference, which likely originates from the different pathophysiologic and hemodynamic features of the two infarction types, might account for the relatively large range of ADC values reported for the time course of ischemic strokes.

Original languageEnglish
Pages (from-to)35-42
Number of pages8
JournalRadiology
Volume221
Issue number1
Publication statusPublished - 2001
Externally publishedYes

Fingerprint

Cerebral Infarction
Infarction
Magnetic Resonance Spectroscopy
Analysis of Variance
Hemodynamics
Stroke
Magnetic Resonance Imaging

Keywords

  • Brain, infarction, 13.4352, 13.781
  • Brain, MR, 13.121413, 13.121416, 13.12144
  • Magnetic resonance (MR), diffusion study, 13.12144

ASJC Scopus subject areas

  • Radiological and Ultrasound Technology

Cite this

Time course of cerebral infarction in the middle cerebral arterial territory : Deep watershed versus territorial subtypes on diffusion-weighted MR images. / Huang, I. J.; Chen, C. Y.; Chung, H. W.; Chang, D. C.; Lee, C. C.; Chin, S. C.; Liou, M.

In: Radiology, Vol. 221, No. 1, 2001, p. 35-42.

Research output: Contribution to journalArticle

Huang, I. J. ; Chen, C. Y. ; Chung, H. W. ; Chang, D. C. ; Lee, C. C. ; Chin, S. C. ; Liou, M. / Time course of cerebral infarction in the middle cerebral arterial territory : Deep watershed versus territorial subtypes on diffusion-weighted MR images. In: Radiology. 2001 ; Vol. 221, No. 1. pp. 35-42.
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AB - PURPOSE: To examine possible differences between the evolution of cerebral watershed infarction (WI) and that of territorial thromboembolic infarction (TI) by using diffusion-weighted (DW) and T2-weighted magnetic resonance (MR) images and apparent diffusion coefficient (ADC) maps. MATERIALS AND METHODS: Fourteen patients with TI and nine with WI underwent MR imaging from the acute to chronic infarction stages. ADC maps were derived from DW images. Lesion-to-normal tissue signal intensity ratios on ADC maps (rADC), echo-planar T2-weighted images, and DW images were calculated. Lesion volumes at acute or early subacute infarction stages were measured on DW images, and final lesion volumes were estimated on fluid-attenuated inversion-recovery images. RESULTS: Analysis of variance revealed a significant difference in temporal evolution patterns of rADC between WI and TI (P <.001). rADC pseudonormalization following TI began about 10 days after symptom onset, but that following WI did not occur until about 1 month after symptom onset. The Pearson correlation coefficient between final and initial infarct volumes was 0.9899 for both infarction subtypes, indicating that the initial ischemic injury volume measured at the acute or early subacute stage predicted the final lesion volume fairly well. CONCLUSION: The evolution time of ADC is faster for TI than for WI. This difference, which likely originates from the different pathophysiologic and hemodynamic features of the two infarction types, might account for the relatively large range of ADC values reported for the time course of ischemic strokes.

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