Krueger K, Kugel H, Grond M, Thiel A, Maintz D, Lackner K
Department of Diagnostic Radiology, University of Cologne, Cologne, Germany.
Stroke. 2000 Nov;31(11):2715-8. doi: 10.1161/01.str.31.11.2715.
Reduced apparent diffusion coefficients (ADCs) correlate with cerebral ischemia. The combination of ADC with techniques to measure cerebral perfusion may help to assess the effect of treatment.
The authors describe a patient who experienced an acute stroke with hemianopia, consequently treated with intravenous recombinant tissue plasminogen activator. Positron emission tomographic imaging and MRI, including diffusion-weighted MRI, were performed during and shortly after treatment with recombinant tissue plasminogen activator and 34 to 35 hours later. Cerebral perfusion of the left occipital region was reduced to 74%. Diffusion-weighted MRI detected a territory of restricted water movement in the corresponding area. Further magnetic resonance sequences did not show any pathologies. In follow-up, positron emission tomography demonstrated reperfusion. The volume of diffusion and ADC abnormalities detected by MRI decreased markedly. A few hours later, the patient recovered completely. A third MRI examination 10 days later showed normal findings.
In a patient with prolonged reversible ischemic neurological deficit, resolution of early diffusion changes corresponded to cerebral reperfusion and to the recovery of clinical symptoms.
表观扩散系数（ADC）降低与脑缺血相关。ADC与测量脑灌注的技术相结合可能有助于评估治疗效果。
作者描述了一名患有急性中风伴偏盲的患者，随后接受了静脉注射重组组织型纤溶酶原激活剂治疗。在使用重组组织型纤溶酶原激活剂治疗期间、治疗后不久以及34至35小时后进行了正电子发射断层扫描成像和MRI检查，包括扩散加权MRI。左枕叶区域的脑灌注降低至74%。扩散加权MRI在相应区域检测到水移动受限的区域。进一步的磁共振序列未显示任何病变。在随访中，正电子发射断层扫描显示再灌注。MRI检测到的扩散和ADC异常体积明显减小。几小时后，患者完全康复。10天后的第三次MRI检查显示结果正常。
在一名患有长时间可逆性缺血性神经功能缺损的患者中，早期扩散变化的消退与脑再灌注及临床症状的恢复相对应。
