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BEYİN DİFÜZYON AĞIRLIKLI MANYETİK REZONANS GÖRÜNTÜLEME TETKİKİNDE AKUT İSKEMİLİ HASTALARDA GÖRÜNEN DİFÜZYON KATSAYISI ÖLÇÜMLERİNİN DEĞERLENDİRİLMESİ

Year 2018, , 106 - 117, 31.08.2018
https://doi.org/10.24938/kutfd.346281

Abstract

Amaç: Difüzyon ağırlıklı görüntüleme ile akut iskemisi olan hastalarda, iskemik
“kor” dan ne kadar uzaklıkta görünen difüzyon
katsayısı değerlerinin normale ulaştığının tespiti amaçlandı.

Gereç ve Yöntem: Akut iskemisi olan 44 hasta çalışmamıza dahil edildi. Difüzyon ağırlıklı
görüntüleme ile iskemi alanı dış sınırına 4mm, 8mm ve 12 mm uzaklıktan dörder
ölçüm yapılarak görünen difüzyon katsayısı değerleri elde edildi. Bu değerler simetrik noniskemik
hemisfer ile istatistiksel olarak kıyaslandı.

Bulgular: Dört ve 8 mm uzaklıktaki dörder ölçümün
ortalaması noniskemik hemisferdeki simetrik ölçümlerin
görünen
difüzyon katsayısı
değerlerinden istatistiksel olarak anlamlı
düzeyde düşük olarak saptanırken, 12 mm uzaklıkta elde olunan ölçümler ile
noniskemik hemisferdeki ölçümler arasında istatistiksel olarak anlamlı
farklılık saptanmadı.







Sonuç: Çalışmamız
verileri ışığında ve mevcut hasta grubunda iskemik kor dokusundan 12 mm
mesafede görünen difüzyon katsayısı
değerlerinin; hücresel düzeyde
difüzyonun karşı hemisferle eş düzeye geldiği sonucuna varılmıştır. Bu
mesafenin manyetik rezonans perfüzyon tetkiki ile kurtarılabilir  penumbra dokusu ile ne kadar
örtüştüğünün saptanması, difüzyon ağırlıklı görüntülemenin kontrastsız ve kısa
sürede elde edilebilen bir tetkik olarak penumbra tespitinde kullanılabilme
olasılıklarını gündeme getirmektedir.

References

  • 1. Kloska SP, Nabavi DG, Gaus C, Nam EM, Klotz E, Ringelstein EB et al. Acute Stroke Assessment with CT: Do We Need Multimodal Evaluation? Radiology. 2004;233(1):79-86.
  • 2. Sudlow CL, Warlow CP. Comparing stroke incidence world wide: what makes studies comparable? Stroke. 1996;27(3):550-8.
  • 3. Bamford J, Sandercock P, Dennis M, Burn J, Warlow C. Classification and natural history of clinically identifiable subtypes of cerebral infarction. Lancet. 1991; 337(8756):1521-6.
  • 4. Oppenheim C, Stanescu R, Dormont D, Crozier S, Marro B, Samson Y. False-negative Diffusion-weighted MR Findings in Acute Ischemic Stroke. AJNR. 2000;21(8):1434-40.
  • 5. Keyik B, Edgüer T, Çakmakçı E, Bakdık S, Hekimoğlu B. Difüzyon ağırlıklı MRG'nin konvansiyonel beyin MRG'ye katkısı. Türk Tanısal ve Girişimsel Radyoloji Dergisi. 2002;8(3):323-9.
  • 6. Hagmann P, Jonasson L, Maeder P, Thiran JP, Wedeen VJ, Meuli R. Understanding Diffusion MR Imaging Techniques: From Scalar Diffusion-weighted Imaging to Diffusion Tensor Imaging and Beyond. RadioGraphics. 2006;26(Suppl 1):S205-23.
  • 7. Koh DM, Collins DJ. Diffusion-Weighted MRI in the Body: Applications and Challenges in Oncology. AJR. 2007;188(6):1622-35.
  • 8. Le Bihan D, Turner R, MacFall JR. Effects of intravoxel incoherent motions (IVIM) in steady-state free precession (SSFP) imaging: Application to molecular diffusion imaging. Magnetic Resonance in Medicine. 1989;10(3):324-37.
  • 9. El-Koussy M, Lövblad KO, Kiefer C, Zeller O, Arnold M, Wels T et al. Apparent diffusion coefficient mapping of infarcted tissue and the ischaemic penumbra in acute stroke. Neuroradiology. 2002; 44(10):812-8.
  • 10. Gauvrit JY, Leclerc X, Girot M, Cordonnier C, Sotoares G, Henon H et al. Fluid-attenuated inversion recovery (FLAIR) sequences for the assessment of acute stroke Inter observer and inter technique reproducibility. J Neurol. 2006; 253(5):631-5.
  • 11. Urbach H, Flacke S, Keller E, Textor J, Berlis A, Hartmann A et al. Detectability and detection rate of acute cerebral hemisphere infarcts on CT and diffusion-weighted MRI. Neuroradiology. 2000;42(10):722-7.
  • 12. Ma L, Gao PY, Hu QM, Lin Y, Jing LN, Xue J et al. Prediction of infarct core and salvageable ischemic tissue volumes by analyzing apparent diffusion coefficient without intravenous contrast material. Acad Radiol. 2010;17(12):1506-17.
  • 13. Montiel NH, Rosso C, Chupin N, Deltour S, Bardinet E, Dormont D et al. Automatic prediction of infarct growth in acute ischemic stroke from MR apparent diffusion coefficient maps. Acad Radiol. 2008;15(1):77-83.
  • 14. Schaefer PW, Ozsunar Y, He J, Hamberg LM, Hunter GJ, Sorensen AG et al. Assessing tissue viability with MR diffusion and perfusion imaging. AJNR. 2003;24(3):436-43.
  • 15. Na DG, Thijs VN, Albers GW, Moseley ME, Marks MP. Diffusion-weighted MR imaging in acute ischemia: value of apparent diffusion coefficient and signal intensity thresholds in predicting tissue at risk and final infarct size. AJNR. 2004;25(8):1331-6.
  • 16. Oppenheim C, Grandin C, Samson Y, Smith A, Duprez T, Marsault C et al. Is there an apparent diffusion coefficient threshold in predicting tissue viability in hyperacute stroke? Stroke. 2001;32(11):2486-91.

Evaluation of Apparent Diffusion Coefficient Measurements of Acute Cerebral Infarct

Year 2018, , 106 - 117, 31.08.2018
https://doi.org/10.24938/kutfd.346281

Abstract

ObjectiveWe aimed to
analyse the distance from the ischemic area where the ADC values normalise.

Material and Methods: Forty-four patients with acute
ischemia were involved in the study. Apparent diffusion coefficient values are measured
at 4mm, 8mm and 12
mm away from the outer boundary of ischemia
and these
apparent diffusion coefficient measurements were compared with symmetrical non-ischemic hemisphere.

Results: The apparent diffusion
coefficient measurements obtained 4 and 8 mm away from the outer boundary of ischemia, were
significantly lower than the apparent diffusion coefficient measurements obtained from
symmetric non-ischemic hemisphere. The measurements obtained 12 mm away from
the outer boundary were not statistically different from symmetric non-ischemic
hemisphere.







Conclusion: The apparent diffusion
coefficient values seem to be normalised at 12 mm away from the outer boundary of ischemia, which should be
analysed with perfusion weighted studies in order to verify how these
measurements can reflect the penumbra tissue.

References

  • 1. Kloska SP, Nabavi DG, Gaus C, Nam EM, Klotz E, Ringelstein EB et al. Acute Stroke Assessment with CT: Do We Need Multimodal Evaluation? Radiology. 2004;233(1):79-86.
  • 2. Sudlow CL, Warlow CP. Comparing stroke incidence world wide: what makes studies comparable? Stroke. 1996;27(3):550-8.
  • 3. Bamford J, Sandercock P, Dennis M, Burn J, Warlow C. Classification and natural history of clinically identifiable subtypes of cerebral infarction. Lancet. 1991; 337(8756):1521-6.
  • 4. Oppenheim C, Stanescu R, Dormont D, Crozier S, Marro B, Samson Y. False-negative Diffusion-weighted MR Findings in Acute Ischemic Stroke. AJNR. 2000;21(8):1434-40.
  • 5. Keyik B, Edgüer T, Çakmakçı E, Bakdık S, Hekimoğlu B. Difüzyon ağırlıklı MRG'nin konvansiyonel beyin MRG'ye katkısı. Türk Tanısal ve Girişimsel Radyoloji Dergisi. 2002;8(3):323-9.
  • 6. Hagmann P, Jonasson L, Maeder P, Thiran JP, Wedeen VJ, Meuli R. Understanding Diffusion MR Imaging Techniques: From Scalar Diffusion-weighted Imaging to Diffusion Tensor Imaging and Beyond. RadioGraphics. 2006;26(Suppl 1):S205-23.
  • 7. Koh DM, Collins DJ. Diffusion-Weighted MRI in the Body: Applications and Challenges in Oncology. AJR. 2007;188(6):1622-35.
  • 8. Le Bihan D, Turner R, MacFall JR. Effects of intravoxel incoherent motions (IVIM) in steady-state free precession (SSFP) imaging: Application to molecular diffusion imaging. Magnetic Resonance in Medicine. 1989;10(3):324-37.
  • 9. El-Koussy M, Lövblad KO, Kiefer C, Zeller O, Arnold M, Wels T et al. Apparent diffusion coefficient mapping of infarcted tissue and the ischaemic penumbra in acute stroke. Neuroradiology. 2002; 44(10):812-8.
  • 10. Gauvrit JY, Leclerc X, Girot M, Cordonnier C, Sotoares G, Henon H et al. Fluid-attenuated inversion recovery (FLAIR) sequences for the assessment of acute stroke Inter observer and inter technique reproducibility. J Neurol. 2006; 253(5):631-5.
  • 11. Urbach H, Flacke S, Keller E, Textor J, Berlis A, Hartmann A et al. Detectability and detection rate of acute cerebral hemisphere infarcts on CT and diffusion-weighted MRI. Neuroradiology. 2000;42(10):722-7.
  • 12. Ma L, Gao PY, Hu QM, Lin Y, Jing LN, Xue J et al. Prediction of infarct core and salvageable ischemic tissue volumes by analyzing apparent diffusion coefficient without intravenous contrast material. Acad Radiol. 2010;17(12):1506-17.
  • 13. Montiel NH, Rosso C, Chupin N, Deltour S, Bardinet E, Dormont D et al. Automatic prediction of infarct growth in acute ischemic stroke from MR apparent diffusion coefficient maps. Acad Radiol. 2008;15(1):77-83.
  • 14. Schaefer PW, Ozsunar Y, He J, Hamberg LM, Hunter GJ, Sorensen AG et al. Assessing tissue viability with MR diffusion and perfusion imaging. AJNR. 2003;24(3):436-43.
  • 15. Na DG, Thijs VN, Albers GW, Moseley ME, Marks MP. Diffusion-weighted MR imaging in acute ischemia: value of apparent diffusion coefficient and signal intensity thresholds in predicting tissue at risk and final infarct size. AJNR. 2004;25(8):1331-6.
  • 16. Oppenheim C, Grandin C, Samson Y, Smith A, Duprez T, Marsault C et al. Is there an apparent diffusion coefficient threshold in predicting tissue viability in hyperacute stroke? Stroke. 2001;32(11):2486-91.
There are 16 citations in total.

Details

Subjects Health Care Administration
Journal Section Articles
Authors

M. Yasemin Bilgili

Canan Hırslı This is me

Publication Date August 31, 2018
Submission Date October 24, 2017
Published in Issue Year 2018

Cite

APA Bilgili, M. Y., & Hırslı, C. (2018). Evaluation of Apparent Diffusion Coefficient Measurements of Acute Cerebral Infarct. The Journal of Kırıkkale University Faculty of Medicine, 20(2), 106-117. https://doi.org/10.24938/kutfd.346281
AMA Bilgili MY, Hırslı C. Evaluation of Apparent Diffusion Coefficient Measurements of Acute Cerebral Infarct. Kırıkkale Üni Tıp Derg. August 2018;20(2):106-117. doi:10.24938/kutfd.346281
Chicago Bilgili, M. Yasemin, and Canan Hırslı. “Evaluation of Apparent Diffusion Coefficient Measurements of Acute Cerebral Infarct”. The Journal of Kırıkkale University Faculty of Medicine 20, no. 2 (August 2018): 106-17. https://doi.org/10.24938/kutfd.346281.
EndNote Bilgili MY, Hırslı C (August 1, 2018) Evaluation of Apparent Diffusion Coefficient Measurements of Acute Cerebral Infarct. The Journal of Kırıkkale University Faculty of Medicine 20 2 106–117.
IEEE M. Y. Bilgili and C. Hırslı, “Evaluation of Apparent Diffusion Coefficient Measurements of Acute Cerebral Infarct”, Kırıkkale Üni Tıp Derg, vol. 20, no. 2, pp. 106–117, 2018, doi: 10.24938/kutfd.346281.
ISNAD Bilgili, M. Yasemin - Hırslı, Canan. “Evaluation of Apparent Diffusion Coefficient Measurements of Acute Cerebral Infarct”. The Journal of Kırıkkale University Faculty of Medicine 20/2 (August 2018), 106-117. https://doi.org/10.24938/kutfd.346281.
JAMA Bilgili MY, Hırslı C. Evaluation of Apparent Diffusion Coefficient Measurements of Acute Cerebral Infarct. Kırıkkale Üni Tıp Derg. 2018;20:106–117.
MLA Bilgili, M. Yasemin and Canan Hırslı. “Evaluation of Apparent Diffusion Coefficient Measurements of Acute Cerebral Infarct”. The Journal of Kırıkkale University Faculty of Medicine, vol. 20, no. 2, 2018, pp. 106-17, doi:10.24938/kutfd.346281.
Vancouver Bilgili MY, Hırslı C. Evaluation of Apparent Diffusion Coefficient Measurements of Acute Cerebral Infarct. Kırıkkale Üni Tıp Derg. 2018;20(2):106-17.

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