Correlation of the apparent diffusion coefficient and the creatine level in early ischemic stroke: A comparison of different patterns by magnetic resonance
H. Rumpel et al., Correlation of the apparent diffusion coefficient and the creatine level in early ischemic stroke: A comparison of different patterns by magnetic resonance, J MAGN R I, 13(3), 2001, pp. 335-343
it has been reported that reduction of the apparent diffusion coefficient (
ADC) after stroke can persist for several days, after which the ADC increas
es gradually to an abnormally high level. We evaluated ADC values of stroke
lesions and compared the results to the cellular density of the lesion by
means of the creatine (Cre) level. This two-parameter estimation is of part
icular relevance in ascertaining the underlying cellular status. Lesion-to-
contralateral ADC ratios (ADC.) were obtained based on diffusion-weighted e
cho-planar and fast spin-echo imaging. Single-voxel localized spectroscopy
was used for quantification of cerebral metabolites in infarcted regions. T
heir levels were also compared to that in homotopic contralateral regions.
Fifteen patients with ischemic stroke were examined at times ranging from 1
8-88 hours following the onset of symptoms. In the stroke lesion, there was
a significant correlation between the ADC and the Cre level showing that t
he higher the cell density the lower the ADC value. For ADC, vs. the lesion
Cre concentration and the lesion-to-contralateral Cre ratio (Cre.), the st
rengths of relationship were R-2 = 0.70 and 0.58, respectively. It is concl
uded that ADC is a good reflection of cell density. Greatly lowered ADC val
ues occur within the context of a stable cellularity. ADC and the Cre level
have complementary roles in the characterization of stroke lesion with reg
ard to the sequential stage. (C) 2001 Wiley-Liss, Inc.