2011/04/01 by Hongyu An, Andria L. Ford, Katie D. Vo +3 · 1 citation
Medicine · #Acute Ischemic Stroke Management #MRI in cancer diagnosis #Advanced Neuroimaging Techniques and Applications
paper · doi:10.1161/strokeaha.110.610501
openalex publication_date 2011/04/01 · openalex created_date 2025/10/10 · openalex updated_date 2026/08/01
BACKGROUND AND PURPOSE: This study aimed to examine the temporal relationship between tissue perfusion and apparent diffusion coefficient (ADC) changes within 6 hours of ischemic stroke onset and how different reperfusion patterns may affect tissue outcome in ADC lesions. METHODS: Thirty-one participants were sequentially imaged at 3 hours, 6 hours, and 1 month post-stroke. Three regions of interest (ROIs) were defined within initial ADC lesions: ROI (1)reperf3hour hyperacute reperfusion (within 3 hours), ROI (2)reperf6hour acute reperfusion (3 to 6 hours), and ROI (3)nonreperf no reperfusion (by 6 hours). For each ROI, changes in ADC (ΔADC) from 3 to 6 hours and risks of infarction were examined. RESULTS: The magnitude of initial ADC reduction was similar in all 3 ROIs (P=0.51). ΔADC was strongly associated with reperfusion (P<0.0001) but not with initial ADC reduction (P=0.83). ΔADC in ROI (1)reperf3hour and ROI (2)reperf6hour was significantly larger than that of ROI (3)nonreperf (P<0.05). Positive ΔADC was obtained from 3 to 6 hours in ROI (1)reperf3hour that had restored perfusion before 3 hours, demonstrating a temporal delay between reperfusion and ADC changes. Risks of infarction were significantly higher in ROI (3)nonreperf than those in ROI (1)reperf3hour and ROI (2)reperf6hour. CONCLUSIONS: Improvement in ADC did not occur coincidently with reperfusion but showed a temporal delay. Regions with similar initial ADC reductions at 3 hours had different evolution of ADC and infarction risks depending on when or if tissue reperfused. These findings provide a physiological basis for the observation that a single ADC measurement at a fixed time after stroke onset may not accurately predict tissue outcome.