Reduced visualization of cerebral infarction on diffusion-weighted images with short diffusion times

Neuroradiology. 2018 Sep;60(9):979-982. doi: 10.1007/s00234-018-2065-6. Epub 2018 Jul 26.

Abstract

Purpose: Diffusion-weighted imaging (DWI) is a useful tool for early detection of cerebral infarction. However, recent reports have demonstrated that DWI with short effective diffusion time (∆eff) can obscure visualization of infarction.

Methods: We report three cases, including four acute-to-subacute infarctions, that demonstrated reduced visualization of the infarctions on DWI with shorter ∆eff.

Results: DWI was performed with different ∆eff: short and long ∆eff, using oscillating gradient spin-echo (OGSE) DWI, and intermediate ∆eff, using pulsed gradient spin-echo (PGSE) DWI. Different apparent diffusion coefficient values (due to different ∆eff) were also observed; these were considered to be the underlying causes of the under-evaluation of infarctions on DWI.

Conclusion: The DWI with shorter ∆eff may obscure infarction. High-performance magnetic resonance imaging scanners with higher maximal gradient strength (Gmax) can perform DWI with shorter ∆eff than scanners with lower Gmax. Therefore, the appropriate ∆eff should be set for the detection of restricted diffusion.

Keywords: Infarction; Ischemia; OGSE; Obscuration of infarction; Short diffusion time.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Aged, 80 and over
  • Cerebral Infarction / diagnostic imaging*
  • Diffusion Magnetic Resonance Imaging / methods*
  • Female
  • Humans
  • Male
  • Time Factors