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Journal of Neuroradiology
Sous presse. Epreuves corrigées par l'auteur. Disponible en ligne depuis le samedi 17 décembre 2011
Doi : 10.1016/j.neurad.2011.09.005
3-T high-b -value diffusion-weighted MR imaging of hyperacute ischemic stroke in the vertebrobasilar territory
Imagerie de diffusion en IRM 3T à b élevé dans l’accident ischémique hyperaigu du territoire vertébobasilaire
 

Michael Lettau a, ⁎ , Mona Laible b, c
a Division of Neuroradiology, Department of Neurosurgery, University of Freiburg Medical Center, Breisacher Str. 64, D-79106 Freiburg, Germany 
b Department of Neurology, University of Freiburg Medical Center, Breisacher Str. 64, D-79106 Freiburg, Germany 
c Department of Neurology, University of Heidelberg, Medical Center Im Neuenheimer Feld 400, D-69120 Heidelberg, Germany 

Corresponding author. Tel.: +49 761 270 5171; fax: +49 761 270 5114.
Summary
Background and purpose

Diffusion-weighted imaging (DWI) is the key method for diagnosing acute ischemic stroke. Applied b values in stroke diffusion studies are usually in the range of 800–1500s/mm2, but progress in magnetic resonance (MR) technology now permits higher b values. However, it is uncertain whether high-b -value DW sequences improve the detection of acute and hyperacute ischemic lesions. The aim of this study is to explore the sensitivity of high b values vs standard b values at 3T in hyperacute stroke in the vertebrobasilar territory.

Material and methods

3-T DWI was performed in referred patients with a clinical diagnosis of hyperacute (<6h from onset) cerebral infarction using conventional MR sequences as well as DW sequences. Examinations included the usual DW sequence (b =1000s/mm2) and two high-b -value DW sequences (b =3000s/mm2 and b =5000s/mm2). Patients with hyperacute stroke in the posterior circulation were included if MR imaging, including the usual DW sequence, was normal or if the diagnosis was uncertain.

Results

In all six studied patients, ischemic lesions were better visualized with high-b -value DWI compared with the usual DWI. On increasing the b value, DW images appeared to be noisier while white-matter tracts became progressively hyperintense.

Conclusion

At 3T, high-b -value DW sequences may be helpful for diagnosing hyperacute infarctions in the vertebrobasilar territory, but further studies are needed to confirm this hypothesis.


Keywords : Diffusion-weighted MR imaging, High b-value, 3T, Hyperacute ischemic stroke, Vertebrobasilar territory


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Introduction
Material and methods  (+)
Results
Discussion
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Disclosure of interest


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