关键词: 脑梗死; 磁共振成像; 诊断显像

Abstract:

Objective To explore the potential value of apparent diffusion coefficient(ADC) based approach in determining ischemic penumbra without intravenous contrast material-enhanced perfusion-weighted imaging(PWI). Methods Forty-nine acute ischemic stroke patients of anterior circulation who underwent multimodal magnetic resonance imaging(MRI) were retrospectively reviewed. Diffusion- and perfusion-weighted imaging lesion volumes were semi-automatically measured by a home made software to determine the presence of penumbra. An automatic image analysis system based on ADC maps (ADC method for short) was also tested in these patients to explore the presence of ischemic penumbra. Comparison was then made between the two methods in determining the penumbra. Results In 49 patients, PWI/DWI mismatch and ADC maps reached an agreement in identifying the presence or absence of ischemic penumbra in 41 cases. It showed no statistical significance in determining penumbra between PWI/DWI mismatch and the ADC based approach (P>0.05). The sensitivity and specificity of the ADC based approach were 88.4% and 50.0%, respectively. Conclusion The ADC based approach may be a feasible and practical tool to determine ischemic penumbra without intravenous contrast media-enhanced PWI.