Studies Of Cerebral Ischemic Stroke Evaluated By DWI And Susceptibility Imaging

Objective Studying the core area and the surrounding tissue with ischemic stroke using DWI and SWI to evaluate the time correlation,how the ischemic stroke affect cerebral oxygen metabolism.Material and methods Collect 19 cases acute ischemic stroke patients as research subjects from June 2012 to December 2013,they hospitalized in neurology department of our hospital,among which 9 males and 10 females,aged 22 to 87 years,mean age of 58.89 ± 14.02 years old.First time diagnosis,patients have routine MR examination(including T1W,T2W,DWI sequence),9 cases have routine MR examination+susceptibility weighted imaging(SWI)on the third days,10 cases have routine MR+SWI sequence checking on the 7th day.Collect 33 cases as normal controls,17 males and 16 females,between the ages of 30 to 83 years old,average age 51.48 ± 14.61 years of age,having conventional MR+SWI sequence scanning.Measure the apparent diffusion coefficient(ADC)values and of the core area and the surrounding area 2cm around core and the corresponding contralateral tissue of stroke patients on the first time diagnosed,the third and 7th days.Use the same method on the SWI to measure the phase value on the third and 7th days.Measure phase values of sagittal sinus and straight sinus on the normal and stroke groups.Results 19 cases of acute ischemic stroke patients,found that 24 infarcts(the infarct with large size as main focus),the distribution of lesions is that:6 patients in the left basal ganglia and 2 cases combined with corona radiata lacunar infarction;4 patients in the right basal ganglia and lcase combined with frontal lacunar infarction;brainstem infarction 6 cases;2 patients in the occipital and 1 case combined with thalamic infarction and in the white matter area of lateral ventricle.3 days group 11 lesions,7 days group 13 lesions.The comparison of acute stroke and review DWI shows that the difference of the ADC value of the core area between three days and seven days to review the group was statistically significant(p<0.001);The difference of ADC value of the surrounding of the core area is statistically significant(p<0.05).The comparison of acute stroke and review SWI shows that the difference of the Phase values in the core area,surrounding the core area and contralateral mirror area on the first three days and the first seven days have no statistical significance(p>0.05).Comparing stroke core area and the surrounding of core area,the Phase values decrease,the difference was statistically significant(p<0.05).Comparing the Phase values of the contralateral lesions and the surrounding of the core area,the core area and the contralateral lesions,the difference is not statistically significant(p>0.05).Comparison of the Phase value of straight sinus and superior sagittal sinus of normal and stroke group shows the Phase value of straight sinus of stroke group were significantly lower than the normal group(p<0.001),the Phase value of superior sagittal sinus compared with normal group was not statistically significant(p>0.05).Conclusions Evaluate ischemic stroke through DWI combined with SWI can provide from the tissue edema to the blood flow change and venous blood oxygen saturation and so on a series of information,not only provide a reference for the quantitative evaluation of the stroke core area and ischemic penumbra,but also have a certain value in the quantitative study of oxygen metabolism,which will hopefully provide some help to the clinical and research work of ischemic stroke in the future.