Diffusion Weighted MR Image Using Single Shot EPI in Patients with Brain Infarction

Oh, Y T; Kim, D T; Jung, E K; Seo, J S; Huh, Y M; Cheon, Y J; Jeon, P; Yoon, P H

Abstract

PURPOSE: To evaluate the usefulness of diffusion weighted MRI (DWI) using the single-shot EPI technique fordiagnosis of stroke.
MATERIALS AND METHODS
Conventional Fast Spin Echo T2-weighted MRI (T2WI) and DWI using thesingle-shot EPI technique were performed in 50 patients with brain infarction. DWI was compared with T2WIaccording to each stage of infarction studied and apparent diffusion coefficient (ADC) maps showing calculated ADCwas aguired. Patients were grouped according to the time interval from symptom onset to MRI performance, asfollows : 0 to 6 hours (hyperacute stage, n=3);6 hours to 2 days (acute stage, n=5);3 to 10 days (subacute stage,n=26); more than 11 days (chronic stage, n=16). RESULT: Hyperacute infarcts were visualized only on DWI. Acuteinfarcts were visualized on both DWI and T2WI, but were wider and showed more conspicuous signal intensity on DWIthan T2WI. At these stages, ADCs of the infarcted area were lower than those of the non-infarcted contralateralside. Subacute and chronic infarcts revealed a relatively equal extent of infarcted area on both T2WI and DWI, andat these stages the ADC of the lesions gradually increased, becoming higher than in the non-infarcted area. Inthree patients, acute and chronic infarctions were bright on T2WI, but on DWI, acute infarction showed high signalintensity and chronic infarction showed low signal intensity, enabling us to discriminate acute from chronicinfarction.
CONCLUSION
DWI using the single-shot EPI technique correctly diagnosed brain infarction, especiallythe hyperacute stage, and was helpful in discriminating the stage of a lesion.