J Korean Radiol Soc.  2002 May;46(5):431-436. 10.3348/jkrs.2002.46.5.431.

Diagnosis and Prediction of Clinical Outcomes in Patients with Acute Lacunar Infarction: Usefulness of Perfusion MR Imaging

• Choi JH
• Jeong GW
• Seo JJ
• Jeong YY
• Jeong TW
• Kang HK
• Cho KH

• KMID: 2200176
• DOI: http://doi.org/10.3348/jkrs.2002.46.5.431

Abstract

PURPOSE
To correlate the findings of perfusion-weighted imaging (PWI) with clinical outcomes in patients with acute lacunar infarction.
MATERIALS AND METHODS
Eleven patients (7 males and 4 females) with acute lacunar infarction who were examined within 50 (mean, 29) hours of the onset of symptoms underwent conventional MRI, diffusion-weighted imaging (DWI) and PWI. Gadolinium (0.2 mmol/kg) was injected at a rate of 2 ml/sec, and PWI was performed using a gradient-echo EPI pulse sequence and the following parameters: TR/TE, 2000/60; flip angle, 90 degree; matrix size, 128X128. Relative cerebral blood volume (rCBV) maps were derived from gadolinium bolus perfusion-weighted images where rCBV ratios between infarcted areas were detected by DWI, and contralateral control areas were obtained. In each case, the resulting rCBV ratio at a lesion site was compared with the clinical outcome determined on the basis of the difference between National Institute Health Stroke Scale (NIHSS) scores at admission and discharge.
RESULTS
With the aid of the time-intensity curve obtained at PWI, the rCBV maps revealed a hypoperfused area in 10 of 11 patients, and there was positive correlation (r=0.81) with clinical outcome.
CONCLUSION
Although PWI has a lower detection rate than DWI, it may be a useful modality for helping determine prognosis in cases of acute lacunar infarction.

Keyword

Brain, infarction; Brain, blood flow; Brain, MR; Magnetic resonance (MR), perfusion study

MeSH Terms

Blood Volume
Diagnosis*
Gadolinium
Humans
Magnetic Resonance Imaging*
Male
Perfusion*
Prognosis
Stroke
Stroke, Lacunar*
Gadolinium