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  • 1
    ISSN: 1433-0407
    Keywords: Schlüsselwörter Magnetresonanztomographie ; Diffusion ; Echo-planar ; Zerebrale Ischämie ; Key words MRI ; Diffusion ; Echo - planar ; Cerebral ischemia
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary Magnetic resonance imaging represents today the most important tool in neuroradiology for both clinical pratice and research. MRI allows imaging of the human body in 2 or 3 dimensions with variable tissue contrast. The natural diffusion of tissue protons can now be used as a supplementary contrast mechanism. Different MRI techniques can be used to obtain clinically useful diffusion-weighted images. These techniques all require the use of strong gradient pulses in order to obtain the diffusion contrast. In the current article, the most important physical principles of diffusion measurement are presented. After a short introduction into the basic physical principles, we will present the prerequisites and limitations of clinically relevant applications today. Finally a few select examples of clinical use of these techniques in the acute diagnosis of stroke will be presented.
    Notes: Zusammenfassung Die Kernspintomographie (Magnetresonanztomographie, MRT) ist das zentrale diagnostische Instrument der Neuroradiologie für die Routinediagnostik, aber auch für Fragestellungen, die Forschung und Lehre betreffen, geworden. Zu den bereits bekannten und erprobten MR-Bildkontrasten ist die Diffusion der Protonen als neuer zusätzlicher Kontrastmechanismus hinzugekommen. In letzter Zeit wurden verschiedene kernspintomographische Techniken beschrieben, die zur Diffusionsbildgebung herangezogen werden können. Dabei verlangen MR-Diffusionssequenzen den Einsatz starker Gradientenpulse, die den Diffusionskontrast erzeugen. Andere, weniger bekannte Techniken lassen sich aber auch auf MR-Geräten mit schwächeren Gradienten einsetzen. Untersuchungen die belegen, daß Art und Ausmaß eines Schlaganfalls mit der MR-Diffusionsbildgebung sehr früh mit hoher Sensitivität nachzuweisen ist, haben diese neue MR-Bildgebungstechnik in das Zentrum von Therapiestrategien für diese häufige Erkrankung gerückt. In der vorliegenden Arbeit werden die wichtigsten physikalischen Grundlagen der MR-Diffusionsmessung vorgestellt. Die heute klinisch einsetzbaren Techniken, deren technische Voraussetzungen und Einschränkungen werden erläutert. Im abschließenden Teil wird die klinische Anwendung dieser neuen Bildgebungstechnik zur Diagnostik von akuten Hirninfarkten anhand einiger Beispiele beschrieben.
    Type of Medium: Electronic Resource
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  • 2
    Electronic Resource
    Electronic Resource
    Springer
    Neuroradiology 42 (2000), S. 184-191 
    ISSN: 1432-1920
    Keywords: Key words Ischaemic stroke ; Diffusion weighted imaging ; Fibrinolysis
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Diffusion-weighted (DWI) echo-planar (EPI) MRI has been used for imaging acute ischaemic stroke. We used DWI and conventional spin-echo (SE) MRI to study the dynamics of ischaemic human stroke. We examined 30 patients (mean age 57.5 years, range 27–82 years, median 57 years) with a diagnosis of stroke. They were examined in the acute (120 min to 47 h, mean 15.3 h), subacute (8 days) and chronic (2–3 months) stages of ischaemia using clinical scores and MRI. Imaging was performed on an 1.5-T imager. Anisotropic DWI with diffusion gradients in all three axes, an isotropic tensor trace pulse DWI sequence and SE MRI were used. In all patients both DWI sequences showed a decrease in the apparent diffusion coefficient (ADC) in the acute stage, even when SE images did not reveal signal abnormalities. Clinical features correlated with lesion site but not size. The ADC was initially 19.6–43 % less than that of nonischaemic tissue and increased to normal after 7 days in conventionally treated patients and after 2–5 days in patients who underwent intra-arterial fibrinolysis. In the chronic stage the ADC rose by up to 254.4 %. In patients who did not undergo fibrinolysis DWI changes correlated with the final infarct size (P 〈 0.05). It was possible to differentiate acute from chronic ischaemic lesions. We conclude that DWI is a sensitive and practicable tool for detecting early cerebral ischaemia. It is possible to predict in the acute stage the final size of an infarct. DWI may be helpful for clinical decisions and for monitoring therapy.
    Type of Medium: Electronic Resource
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