Application Of Diffusion Weighted Imaging And Magnetic Resonance Spectroscopy In Diagnosis And Following-Up Of Cerebral Venous Infarction

Objective: To explore the value of diffusion weighted imaging (DWI) and proton magnetic resonance spectroscopy (1H-MRS) in the diagnosis and following-up of cerebral venous infarction (CVI).Methods: Fifteen patients with clinically or radiologically proved CVI underwent conventional MRI, contrast enhanced magnetic resonance venography (CE-MRV) and DWI before and after treatment. Additionally three of them underwent MRS, the DWI and MRS findings and changes during following-up were analyzed.Results: Twenty-six lesions were detected in 15 patients by conventional MRI and DWI. DWI showed hyperintensity (8 lesions), slight hyerintensity (13 lesions), mixed intensity (3 lesions) and isointensity (2 lesions) before treatment, while hyperintensity (2 lesions), slight hyerintensity (6 lesions), mixed intensity (4 lesions) and isointensity (14 lesions) after treatment. The difference of signal intensity on DWI had statistical significance(p<0.05)before and after treatment. The ADC values were (5.09±2.04)×10~-4 mm~2/s before treatment and (6.25±0.76)×10~-4 mm2/s after treatment(t=-2.72, P<0.05). Nine lesions were detected in 3 patients whom underwent MRS, conventional MRI and DWI. DWI showed hyperintensity (2 lesions), slight hyerintensity (4 lesions) and mixed intensity (3 lesions) before treatment, while slight hyerintensity (2 lesions), mixed intensity (4 lesions) and isointensity (3 lesions) after treatment. 7 lesions MRS findings were taken into analysis, except 2 small lesions. NAA and NAA/Cr in the lesions were decreased (P<0.05)before treatment, while NAA and NAA/Cr in the lesions were little decreased than the mirror-side brain tissue(P>0.05)after treatment. Lac was detected in the lesions before treatment, while Lac and Lac/Cr were decreased (P<0.05) after treatment.Conclusion: DWI can demonstrate CVI early, define the type of edema, therefore having important clinical value in the diagnosis and following-up of CVI combined with conventional MRI and CE-MRV. MRS can accurately demonstrate location, scope and state of CVI, offer pathophysiological information for diagnosis, evaluating effect of treatment and predicting outcome of CVI combined with conventional MRI and functional MRI in metabolism, function and morphology.