J Korean Neurol Assoc.  2001 Mar;19(2):88-95.

Diffusion Weighted MRI and Tc99m-ECD SPECT inAcute Middle Cerebral Artery Territory Infarction: Comparison with Clinical Status and Outcome Using Volumetric Analysis"

• Hwang IY
• Lee SM
• Choi SM
• Cho YH
• Kim BC
• Kim MK
• Cho KH
• Song HC
• Bom HS
• Seo JJ

Abstract

BACKGROUND: Diffusion weighted magnetic resonance imaging (DWI) and single photon emission computed tomography (SPECT) can demonstrate ischemic brain injury within the first several hours after the onset of symptoms. We investigated the utility of combined DWI and SPECT in the assessment of acute cerebral infarction.
METHODS
Nineteen patients with acute middle cerebral artery territory infarction underwent DWI and SPECT within 12 hours of symptom onset (mean, 9.6 hour). In SPECT, we defined abnormality as a perfusion defect region (perfusion ??30% compared to a normal cortex) and an ischemic region (perfusion difference ??10% compared to a contralateral normal hemisphere). The initial DWI and SPECT lesion volume ratios (lesion volume / hemispheric volume) were analyzed with subsequent neurological deficits as determined by the National Institutes of Health Stroke Scale (NIHSS) score and Barthel index (BI).
RESULTS
There was a high correlation between clinical scores within 7 days and lesion volumes determined by DWI and SPECT respectively (p<0.05). The lesion volumes detected by DWI and SPECT significantly correlated with each other (p<0.01). Ischemic lesions on SPECT were larger in the group (n=10) with ICA occlusions than in the other group (p=0.034). In 15 patients with cortical lesions, the ratio of perfusion defect volumes on SPECT to lesion volumes on DWI was higher in the group with favorable outcome than in the group with unfavorable outcome (p=0.01).
CONCLUSIONS
Both DWI and SPECT are highly correlated with the severity of neurological deficit in acute cerebral infarction. Furthermore, combined use of DWI and SPECT would be more powerful than either study alone in predicting clinical outcome. (J Korean Neurol Assoc 19(2):88~95, 2001)

Keyword

Diffusion weighted magnetic resonance imaging; Stroke assessment; Single-photon emission computed tomography; Acute cerebral infarction

MeSH Terms

Brain Injuries
Cerebral Infarction
Diffusion Magnetic Resonance Imaging*
Diffusion*
Humans
Infarction*
Magnetic Resonance Imaging
Middle Cerebral Artery*
National Institutes of Health (U.S.)
Perfusion
Stroke
Tomography, Emission-Computed, Single-Photon*