BACKGROUND AND PURPOSE: Intravascular and parenchymal enhancement have been detected with contrast-enhanced T1-weighted MR imaging in patients with ischemic stroke. Diffusion-weighted MR imaging depicts infarct within minutes after the onset of symptoms. The aims of this study were to study the different MR enhancement findings during the first week after stroke and to ascertain whether the presence of intravascular enhancement over a larger area than the infarct on diffusion-weighted images on day 1 is able to predict substantial infarct growth during the first week. METHODS: Forty-eight patients were imaged on the first and second days and again 1 week after the onset of ischemic stroke. T1-weighted spin-echo imaging was performed before and after a 0.2 mmol/kg bolus of gadolinium chelate. Diffusion-weighted imaging was performed at the same slice positions. Enhancement findings were categorized as intravascular and parenchymal, with further categorization of parenchymal enhancement as cortical, subcortical, and deep; these findings were then compared with diffusion-weighted imaging findings. RESULTS: Intravascular enhancement in the infarcted area was detected on day 1 in 78% of the cases, on day 2 in 78% of the cases, and at 1 week in 30% of the cases. Parenchymal enhancement was detected in 26%, 56%, and 100% of the cases, respectively. Intravascular enhancement over a larger area than the infarct on diffusion-weighted images on day 1 was not associated with the extent of infarct growth. CONCLUSION: Detection of different patterns of contrast enhancement can help in determining the age of infarct. Parenchymal enhancement may be intense and can cause diagnostic uncertainty in cases in which the clinical history is obscure.
BACKGROUND AND PURPOSE: Intravascular and parenchymal enhancement have been detected with contrast-enhanced T1-weighted MR imaging in patients with ischemic stroke. Diffusion-weighted MR imaging depicts infarct within minutes after the onset of symptoms. The aims of this study were to study the different MR enhancement findings during the first week after stroke and to ascertain whether the presence of intravascular enhancement over a larger area than the infarct on diffusion-weighted images on day 1 is able to predict substantial infarct growth during the first week. METHODS: Forty-eight patients were imaged on the first and second days and again 1 week after the onset of ischemic stroke. T1-weighted spin-echo imaging was performed before and after a 0.2 mmol/kg bolus of gadolinium chelate. Diffusion-weighted imaging was performed at the same slice positions. Enhancement findings were categorized as intravascular and parenchymal, with further categorization of parenchymal enhancement as cortical, subcortical, and deep; these findings were then compared with diffusion-weighted imaging findings. RESULTS: Intravascular enhancement in the infarcted area was detected on day 1 in 78% of the cases, on day 2 in 78% of the cases, and at 1 week in 30% of the cases. Parenchymal enhancement was detected in 26%, 56%, and 100% of the cases, respectively. Intravascular enhancement over a larger area than the infarct on diffusion-weighted images on day 1 was not associated with the extent of infarct growth. CONCLUSION: Detection of different patterns of contrast enhancement can help in determining the age of infarct. Parenchymal enhancement may be intense and can cause diagnostic uncertainty in cases in which the clinical history is obscure.
Authors: A G Sorensen; W A Copen; L Ostergaard; F S Buonanno; R G Gonzalez; G Rordorf; B R Rosen; L H Schwamm; R M Weisskoff; W J Koroshetz Journal: Radiology Date: 1999-02 Impact factor: 11.105
Authors: R N Bryan; L M Levy; W D Whitlow; J M Killian; T J Preziosi; J A Rosario Journal: AJNR Am J Neuroradiol Date: 1991 Jul-Aug Impact factor: 3.825
Authors: J O Karonen; R L Vanninen; Y Liu; L Ostergaard; J T Kuikka; J Nuutinen; E J Vanninen; P L Partanen; P A Vainio; K Korhonen; J Perkiö; R Roivainen; J Sivenius; H J Aronen Journal: Stroke Date: 1999-08 Impact factor: 7.914
Authors: M T McNamara; M Brant-Zawadzki; I Berry; B Pereira; P Weinstein; N Derugin; S Moore; W Kucharczyk; R C Brasch Journal: Radiology Date: 1986-03 Impact factor: 11.105
Authors: S Imakita; T Nishimura; N Yamada; H Naito; M Takamiya; Y Yamada; J Minamikawa; H Kikuchi; M Nakamura; T Sawada Journal: Neuroradiology Date: 1988 Impact factor: 2.804
Authors: Juho Nuutinen; Yawu Liu; Mikko P Laakso; Jari O Karonen; Esko J Vanninen; Jyrki T Kuikka; Hannu J Aronen; Ritva L Vanninen Journal: Neuroradiology Date: 2009-07-22 Impact factor: 2.804
Authors: N Gaillard; C Schmidt; V Costalat; J P Bousquet; C Heroum; D Milhaud; A Bonafe; C Arquizan Journal: AJNR Am J Neuroradiol Date: 2011-11-24 Impact factor: 3.825
Authors: Lalanthica V Yogendran; Tuba Kalelioglu; Joseph H Donahue; Haroon Ahmad; Kester A Phillips; Nicole M Calautti; Maria-Beatriz Lopes; Ashok R Asthagiri; Benjamin Purow; David Schiff; Sohil H Patel; Camilo E Fadul Journal: J Neurooncol Date: 2022-07-20 Impact factor: 4.506
Authors: Paula Barreras; Kathryn C Fitzgerald; Maureen A Mealy; Jorge A Jimenez; Daniel Becker; Scott D Newsome; Michael Levy; Philippe Gailloud; Carlos A Pardo Journal: Neurology Date: 2017-12-01 Impact factor: 9.910