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Date Published: 15/06/2022
Online Published: 29/11/2020
Abstract Views: 425
Views PDF: 267
DOI: https://doi.org/10.55046/vjrnm.40.205.2020
Issue
No. 40 (2020)
Section
Scientific research
How to Cite
Nguyen, V. L., Vo, T. T. H., Le, Q. K., Nguyen, T. P. L., Phan, C. C., & Pham, N. H. (2020). Investigation of characteristics of acute ischemic stroke on conventional magnetic resonance imaging and angiography using TOF 3D technique. Vietnamese Journal of Radiology and Nuclear Medicine, 40, 80-86. https://doi.org/10.55046/vjrnm.40.205.2020

Investigation of characteristics of acute ischemic stroke on conventional magnetic resonance imaging and angiography using TOF 3D technique

Nguyen Viet Loi1, Vo Thi Thuy Hang2, Le Quang Khang2, Nguyen Thi Phuong Loan2, Phan Cong Chien3, Pham Ngoc Hoa3
1 Military Hospital 175
2 HCMC University of Medicine and Pharmacy
3 Ho Chi Minh City University of Medicine and Pharmacy Hospital

Main Article Content

Abstract

Objective. To describe the characteristics of acute ischemic stroke on conventional magnetic resonance imaging (MRI) and angiography using TOF 3D technique and to evaluate the time course of the apparent diffusion coefficient after cerebral infarction.
Materials and Methods. We conducted a retrospective study in 221 patients with acute ischemic stroke who were performed MRI at the University Medical Center Hospital between January 2018 and December 2020. A radiologist who had more than 5 years of experience of MRI evaluates the changes of signal intensity on these sequences: T1- weighted, T2-weighted, FLAIR, DWI/ADC, Susceptibility weighted imaging (SWI) and TOF3D.


Results: The study was composed of 221 patients (136 males, 85 females). The mean age of patients was 64.5 ± 13.7 years (range, 28-96 years). 60 - 79 age group accounts for the majority with 105 people (47.5%). Anterior cerebral artery territory infarcts and cerebral peduncular infarction were the least common (1.1%). The rate of brain parenchymal signal abnormalities on the T1W, T2W, FLAIR, DWI / ADC sequences respectively was 85.5%, 87.3%, 90.0%, and 97.3%. The rate of a significant decrease in vascular signaling on TOF3D was 35.7%. The rate of susceptibility vessel sign and prominent vessel sign on SWI was 21.8% và 9.1% respectively. Immediately following a cerebral infarction, the relative ADC (rADC) value begins to decrease gradually and reaches its
lowest level between day 2 and 4. Thereafter the rADC value increases gradually and reaches a pseudonormalization around day 7.
Conclusion: Magnetic resonance imaging is of high value in the diagnosis of acute ischemic stroke. Diffusion imaging has the highest sensitivity in lesion detection. TOF3S and SWI were helpful in depiction the vascular signaling, the susceptibility vessel sign and prominent vessel sign. Immediately following a cerebral infarction, the relative ADC (rADC) value begins to decrease gradually and reaches its lowest level between day 2 and 4. Thereafter the rADC value increases gradually and reaches a pseudonormalization around day 7.

Article Details

Keywords

acute ischemic stroke, magnetic resonance imaging

References

1 Guzik, A. & Bushnell, C. Stroke Epidemiology and Risk Factor Management. Continuum (Minneap Minn) 23, 15-39, doi:10.1212/con.0000000000000416 (2017).
2 Mozaffarian, D. et al. Heart Disease and Stroke Statistics-2016 Update: A Report From the American Heart Association. Circulation 133, e38-360, doi:10.1161/cir.0000000000000350 (2016).
3 Aubrey George Smith & Chris Rowland Hill. Imaging assessment of acute ischaemic stroke: a review of radiological methods. The British Journal of Radiology 91, 20170573, doi:10.1259/bjr.20170573 (2018).
4 Edlow, B. L., Hurwitz, S. & Edlow, J. A. Diagnosis of DWI-negative acute ischemic stroke: A meta-analysis. Neurology 89, 256-262, doi:10.1212/WNL.0000000000004120 (2017).
5 Jauch, E. C. et al. Guidelines for the early management of patients with acute ischemic stroke: a guideline for healthcare professionals from the American Heart Association/American Stroke Association. Stroke 44, 870-947, doi:10.1161/STR.0b013e318284056a (2013).
6 Simonsen, C. Z. et al. Sensitivity of diffusion- and perfusion-weighted imaging for diagnosing acute ischemic stroke is 97.5%. Stroke 46, 98-101, doi:10.1161/strokeaha.114.007107 (2015).
7 Copen, W. A. et al. Ischemic Stroke: Effects of Etiology and Patient Age on the Time Course of the Core Apparent Diffusion Coefficient. Radiology 221, 27-34, doi:10.1148/radiol.2211001397 (2001).
8 Maeda, M., Yamamoto, T., Daimon, S., Sakuma, H. & Takeda, K. Arterial Hyperintensity on Fast Fluid-attenuated Inversion Recovery Images: A Subtle Finding for Hyperacute Stroke Undetected by Diffusion-weighted MR Imaging. American Journal of Neuroradiology 22, 632-636 (2001).
9 Kim, B. J. et al. Magnetic resonance imaging in acute ischemic stroke treatment. Journal of stroke 16, 131-145, doi:10.5853/jos.2014.16.3.131 (2014).10 Thomalla, G. et al. DWI-FLAIR mismatch for the identification of patients with acute ischaemic stroke within 4·5 h of symptom onset (PRE-FLAIR): a multicentre observational study. The Lancet. Neurology 10, 978-986, doi:10.1016/s1474-4422(11)70192-2 (2011).
11 Axer, H. et al. Time course of diffusion imaging in acute brainstem infarcts. Journal of Magnetic Resonance Imaging 26, 905-912, doi:https://doi.org/10.1002/jmri.21088 (2007).
12 Liang, J. et al. Susceptibility-weighted imaging in post-treatment evaluation in the early stage in patients with acute ischemic stroke. Journal of International Medical Research 47, 196-205, doi:10.1177/0300060518799019 (2018).
13 Park, M. G., Yoon, C. H., Baik, S. K. & Park, K. P. Susceptibility Vessel Sign for Intra-arterial Thrombus in Acute Posterior Cerebral Artery Infarction. J Stroke Cerebrovasc Dis 24, 1229-1234, doi:10.1016/j. jstrokecerebrovasdis.2015.01.021 (2015).
14 Boujan, T. et al. Value of Contrast-Enhanced MRA versus Time-of-Flight MRA in Acute Ischemic Stroke MRI. AJNR Am J Neuroradiol 39, 1710-1716, doi:10.3174/ajnr.A5771 (2018).