Neuroradiology

Ischemic Stroke: Effects of Etiology and Patient Age on the Time Course of the Core Apparent Diffusion Coefficient

Abstract

PURPOSE: To determine whether the evolution of the core apparent diffusion coefficient (ADC) of water in ischemic stroke varies with patient age or infarct etiology.

MATERIALS AND METHODS: One hundred forty-seven patients with stroke underwent 236 diffusion-weighted magnetic resonance imaging examinations. Etiologies of lesions were classified according to predefined criteria; in 224 images, the diagnosis of lacune could be firmly established or excluded. ADC was measured in the center of each lesion and in contralateral normal-appearing brain. A model was used to describe the time course of relative ADC (rADC), which is calculated by dividing the lesion ADC by the contralateral ADC, and to test for age- or etiology-related differences in this time course.

RESULTS: Transition from decreasing to increasing rADC was estimated at 18.5 hours after stroke onset. In subgroup analysis, transition was earlier in nonlacunes than in lacunes (P = .02). There was a trend toward earlier transition in patients older than the median age of 66.0 years, compared with younger patients (P = .06). Pseudonormalization was estimated at 216 hours. Among nonlacunes, the rate of subsequent rADC increase was more rapid in younger patients than in older patients (P = .001). Within the smaller sample of lacunes, however, no significant age-related difference in this rate was found.

CONCLUSION: Differences in ADC depending on the patient’s age and infarct etiology suggest differing rates of ADC progression.

References

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Published in print: Oct 2001

Vol. 221, No. 1

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