Kohno K, Ohta S, Kohno K, Kumon Y, Sakaki S, Okujima S
Department of Neurological Surgery, Ehime University School of Medicine, Japan.
J Comput Assist Tomogr. 1995 Nov-Dec;19(6):982-6. doi: 10.1097/00004728-199511000-00027.
We performed serial diffusion-weighted imaging (DWI) in a patient with right middle cerebral arterial occlusion using 1.0 T MRI. The initial DWI demonstrated suppression of water diffusion in the gray matter in the ischemic lesion as a high signal area 4 h after stroke onset, when T2-weighted imaging failed to detect any parenchymal injury. Repeat DWI 9 h after onset demonstrated the whole infarct, whereas it was not demonstrated by T2-weighted imaging until 48 h. Furthermore, the regional apparent diffusion coefficient (ADC) had already decreased significantly in both the gray and white matters of the ischemic lesion 4 h after onset, even though hyperintensity was not visible in the white matter on the DWI. The features in this case indicate that DWI in conjunction with the assessment of regional ADC can provide important information regarding the evolving infarct at a very early stage even when a relatively low tesla clinically available MRI unit is used.
我们使用1.0T磁共振成像（MRI）对一名右侧大脑中动脉闭塞患者进行了系列扩散加权成像（DWI）检查。发病4小时后，初始DWI显示缺血性病变灰质中的水扩散受到抑制，表现为高信号区，此时T2加权成像未能检测到任何实质损伤。发病9小时后重复DWI显示出整个梗死灶，而T2加权成像直到48小时才显示出来。此外，发病4小时后，尽管在DWI上白质未见高信号，但缺血性病变的灰质和白质区域表观扩散系数（ADC）已显著降低。该病例的特征表明，即使使用临床可用的相对低场强MRI设备，DWI结合区域ADC评估也能在极早期提供有关梗死灶演变的重要信息。
