Affiliation:
1. Department of Radiology Fujian Medical University Union Hospital Fuzhou China
2. Department of Radiology, Guangzhou First People's Hospital, School of Medicine South China University of Technology Guangzhou China
3. Department of Medical Imaging, State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer Sun Yat‐sen University Cancer Center Guangzhou China
4. Department of Radiology, The Central Hospital of Wuhan, Tongji Medical College Huazhong University of Science and Technology Wuhan China
Abstract
PurposeTo explore the application value of high‐b‐value and ultra‐high b‐value DWI in noninvasive evaluation of ischemic infarctions.Study TypeProspective.SubjectsSixty‐four patients with clinically diagnosed ischemic lesions based on symptoms and DWI.Field Strength/Sequence3.0 T/T2‐weighted fast spin‐echo, fluid‐attenuated inversion recovery, pre‐contrast T1‐weighted magnetization prepared rapid gradient echo sequence, multi‐b‐value trace DWI and q‐space sampling sequences.AssessmentLesions were segmented on standard b‐value DWI (SB‐DWI, 1000 s/mm2), high b‐value DWI (HB‐DWI, 4000 s/mm2) and ultra‐high b‐value DWI (UB‐DWI, 10,000 s/mm2), and cumulative segmented areas were the final abnormality volumes. Normal white matter (WM) areas were obtained after binarization of segmented brain. In 47 patients, fractional anisotropy (FA) and apparent diffusion coefficients (ADCs) at b values of 1000, 4000, and 10,000 s/mm2 were extracted from symmetrical WM masks and lesion masks of contralateral WM (CWM) and lesion‐side WM (LWM).Statistical TestsWilcoxon matched‐pairs signed‐rank test and Pearson correlation analysis. Two‐tailed P‐values <0.05 were considered statistically significant.ResultsVarious signals of HB‐/UB‐DWI (hypo‐, iso‐ or hyper‐intensity) were observed in strokes compared with SB‐DWI, and some areas with iso‐intensity of SB‐DWI manifested with hyper‐intensity on HB‐/UB‐DWI. Abnormality volumes from SB‐DWI were significantly smaller than those from HB‐DWI and UB‐DWI (10.32 ± 16.45 cm3, vs. 12.25 ± 19.71 cm3 and 11.83 ± 19.41 cm3), while no significant difference exist in volume between HB‐DWI and UB‐DWI (P = 0.32). In CWM, FA significantly correlated with ADC4000 and ADC10,000 (maximum r = −0.51 and −0.64), but did not significantly correlate with ADC1000 (maximum r = −0.20, P = 0.17). ADC1000 or ADC4000 of LWM not significant correlated with FA of CWM (maximum r = −0.28, P = 0.06), while ADC10,000 of LWM significantly correlated with FA of CWM (maximum r = −0.46).Data ConclusionHB‐ and UB‐DWI have potential to be supplementary tools for the noninvasive evaluation of stroke lesions in clinics.Evidence Level2Technical EfficacyStage 2
Funder
National Natural Science Foundation of China
Basic and Applied Basic Research Foundation of Guangdong Province