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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
    ISSN: 1432-1920
    Keywords: Key words Stroke ; Magnetic resonance imaging ; Diffusion-weighted imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Diffusion-weighted MRI (DWI) is becoming important for assessment of acute stroke. Until recently single-shot DWI required expensive technology such as echo-planar imaging (EPI) available only at some research sites. A new medium-field (1.0 T) short-bore MR imager has been developed with which DWI data sets can be acquired. We prospectively studied 169 patients on this 1.0 T commercial system. After conventional imaging, DWI was performed with a single-shot multi-slice sequence with b values 0 an 900 s/mm2, and with the gradients switched in three directions. The apparent diffusion coefficients were calculated with online calculation software. There were 50 patients with totally normal MRI, and 17 had strokes, these strokes were detected as areas of high signal on the images at a maximal b value. There was a drop in the ADC in ischaemic regions: in subacute infarcts, the values were between 0.41 and 0.531 × 10− 3 mm2/s. In old infarcts the ADC was 1.15 × 10− 3 mm2/s. Cerebrospinal fluid (CSF) gave low signal whereas areas in the brain had more intermediate intensities (CSF: 3.00; deep white matter: 0.75, cortical grey matter: 0.80, basal ganglia (thalamus): 0.70 and cerebellar white matter: 0.65 × 10− 3 mm2/s. Anisotropy was detected as areas of restricted diffusion along the tracts. These preliminary data show that DWI can be aquired successfully on a medium-field short-bore system. This should allow the technique to be implemented at more sites, therefore facilitating the diagnosis of acute stroke and rendering early intervention feasible.
    Type of Medium: Electronic Resource
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