Department of Radiology, The Second Affiliated Hospital of Xiamen Medical College, Xiamen, Fujian, China.
Department of Radiology, The Affiliated Hospital of Yanbian University, Yanbian, Jilin, China.
Technol Health Care. 2023;31(S1):525-532. doi: 10.3233/THC-236046.
Diffusion-weighted magnetic resonance imaging (DWI) is a mature scanning technique. With high sensitivity in detecting cerebral infractions, it has become an essential part of the clinical evaluation of acute stroke. However, with the update in medical ideals and treatment, clinicians are now focusing on distinguishing between reversible and irreversible brain tissue damage rather than detecting ischaemic lesions alone.
We supposed that Diffusion Kurtosis Imaging (DKI) could classify heterogeneous DWI lesions, deepening the understanding of tissue injury. We systematically studied the different parameters of DKI in acute stroke patients in the literature.
We collected 41 patients (26 male, 15 female), including different infarctions with acute cerebral infarction in different brain regions. Of all patients, 20 were single-infarction, while others were multi-infarctions. In this paper, we categorized acute cerebral infarction lesions into two types according to the parametric characteristics of both DKI and DWI. Type I means the DKI and DWI were matched, and Type II means the DKI and DWI were mismatched. Based on each parametric map, the region of interest (ROI) is outlined in each most severe lesion area (as large as possible in the center of the lesion). In the control group, ROIs of the same size are located in the corresponding regions of the contralateral hemisphere.
In both Type I and Type II, all parameters conform to a normal distribution. An independent sample T-test was used to compare the differences between each group. In Type I, we found the FA, MD, Da, Dr, MK and Ka values were statistically different (P< 0.05), while in Type II, only the MK and Ka values were statistically different (P< 0.05).
DKI, compared to DWI, can provide more imaging information about intracranial ischemic infarction, which can deepen the understanding of the mechanism of ischemic tissue damage. Our classification of the brain acute stroke lesions by DKI parameters and DWI may help us rediscover the real core of infraction.
弥散加权磁共振成像（DWI）是一种成熟的扫描技术。它在检测脑梗死方面具有很高的敏感性，已成为急性脑卒中临床评估的重要组成部分。然而，随着医学理念和治疗方法的更新，临床医生现在更加关注区分可逆性和不可逆性脑组织损伤，而不仅仅是检测缺血性病变。
我们假设弥散峰度成像（DKI）可以对异质的 DWI 病变进行分类，从而加深对组织损伤的认识。我们系统地研究了文献中急性脑卒中患者的 DKI 不同参数。
我们收集了 41 名患者（26 名男性，15 名女性），包括不同部位的急性脑梗死。所有患者中，20 名患者为单发梗死，其余患者为多发梗死。在本文中，我们根据 DKI 和 DWI 的参数特征将急性脑梗死病变分为两类。I 型表示 DKI 和 DWI 匹配，II 型表示 DKI 和 DWI 不匹配。基于每个参数图，在每个最严重病变区域（尽可能在病变中心）勾勒出感兴趣区（ROI）。在对照组中，相同大小的 ROI 位于对侧半球的相应区域。
在 I 型和 II 型中，所有参数均符合正态分布。采用独立样本 T 检验比较各组间的差异。在 I 型中，我们发现 FA、MD、Da、Dr、MK 和 Ka 值存在统计学差异（P<0.05），而在 II 型中，仅 MK 和 Ka 值存在统计学差异（P<0.05）。
与 DWI 相比，DKI 可以提供更多关于颅内缺血性梗死的影像学信息，从而加深对缺血性组织损伤机制的认识。我们通过 DKI 参数和 DWI 对脑急性卒中病变的分类可能有助于我们重新发现梗死的真正核心。
