伴有或不伴有缺血性梗死的一过性神经血管症状患者的计算机弥散加权成像

IF 3 3区 医学 Q2 CLINICAL NEUROLOGY Journal of Neuroradiology Pub Date : 2024-02-01 DOI:10.1016/j.neurad.2023.02.007
A. Förster , Ana Ramos , H. Wenz , C. Groden , A. Alonso
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引用次数: 0

摘要

目的检测一过性神经血管症状患者的缺血性病变与估计后续中风风险和病因分类有关。为了提高检测率,人们采用了不同的技术方法,如高 b 值或更高磁场强度的弥散加权成像(DWI)。方法从磁共振成像报告数据库中,我们确定了重复接受磁共振成像(包括 DWI)的一过性神经血管症状患者。结果共纳入 33 名有短暂神经血管症状的患者(71 [IQR 57-83.5] 岁;21 [63.6%] 名男性)。在 DWI 上,22 例患者(78.6%)观察到急性缺血性病变。在初始 DWI 中观察到急性缺血性病变的患者有 17 人(51.5%),在随访 DWI 中观察到急性缺血性病变的患者有 26 人(78.8%)。与标准 DWI 相比,2000s/mm2 的 cDWI 病变可探测性明显更好。有 2 例(9.1%)患者在复查标准 DWI 时发现了急性缺血性病变,而在最初的标准 DWI 中并未确定检测到该病变。b 值为 2000s/mm2 似乎最适合临床实践。
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Computed diffusion-weighted imaging in patients with transient neurovascular symptoms with and without ischemic infarction

Purpose

Detection of ischemic lesions in patients with transient neurovascular symptoms is relevant for the estimation of the risk of a subsequent stroke and etiological classification. To improve detection rates, different technical approaches have been used, such as diffusion-weighted imaging (DWI) with high b-values or higher magnetic field strength. Here, we sought to investigate the value of computed DWI (cDWI) with high b-values in these patients.

Methods

From an MRI report database we identified patients with transient neurovascular symptoms who underwent repeated MRI including DWI. cDWI was calculated with a monoexponential model with high b-values (2000, 3000, and 4000 s/mm2) and compared to the routinely used standard DWI with regard to presence of ischemic lesions and lesion detectability.

Result

Overall 33 patients with transient neurovascular symptoms (71 [IQR 57–83.5] years; 21 [63.6%] male) were included. On DWI, acute ischemic lesions were observed in 22 (78.6%). Acute ischemic lesions were observed in 17 (51.5%) patients on initial DWI, and in 26 (78.8%) patients on follow-up DWI. Lesion detectability was rated significantly better on cDWI at 2000s/mm2 compared to standard DWI. In 2 (9.1%) patients, cDWI at 2000s/mm2 revealed an acute ischemic lesion proven on follow-up standard DWI which was not detected with certainty on the initial standard DWI.

Conclusion

cDWI might be a valuable addition to routinely acquired standard DWI in patients with transient neurovascular symptoms since its use might result in improved ischemic lesion detection. A b-value of 2000s/mm2 seems most promising for clinical practice.

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来源期刊
Journal of Neuroradiology
Journal of Neuroradiology 医学-核医学
CiteScore
6.10
自引率
5.70%
发文量
142
审稿时长
6-12 weeks
期刊介绍: The Journal of Neuroradiology is a peer-reviewed journal, publishing worldwide clinical and basic research in the field of diagnostic and Interventional neuroradiology, translational and molecular neuroimaging, and artificial intelligence in neuroradiology. The Journal of Neuroradiology considers for publication articles, reviews, technical notes and letters to the editors (correspondence section), provided that the methodology and scientific content are of high quality, and that the results will have substantial clinical impact and/or physiological importance.
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