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• Clinical Article •
Clinical study of magnetic resonance diffusion kurtosis imaging technology on half dark with acute cerebral infarction diagnosis value
ZHANG Qin-cheng  WANG Guang-wen  GUO Yue-lin  ZHENG Xiao-hong  CHEN Wei 

DOI:10.12015/issn.1674-8034.2017.07.002.


[Abstract] Objective: The purpose of this study was to analyze the clinical value of diffusional kurtosis imaging on diagnosis, prognosis and observation of curative effect of ischemic penumbra.Materials and Methods: Forty-three patients were divided into superacute stage group (n=13), acute stage group (n=14) and subacute group (n=16). All the patients were examined with conventional MRI, DTI, DKI and T2-FLAIR, measured the area of abnormal signal of MK and MD maps. MK values and MD values of the corresponding parts of the mirror side were used as controls. These data were used for statistical analysis.Results: (1) The MD maps of our three groups in the lesion side showed relatively homogeneous low signal with fuzzy edge, in comparison, the MK maps showed heterogeneous high signal with clear edge. (2) In the lesion, the increase in the MK value, decrease in the MD value was different from that of the reference side (P<0.01). (3) The lesion area (mm2)in the MK map was obviously smaller than that in the MD map, with their difference being the mismatch area. The mismatch occurrence rate were 86.4%, 92.8%, 75.0% respectively in superacute, acute and subacute group. (4) ∆MK was apparently greater than ∆MD in the lesion. (5) MK, MD, ∆MK, ∆MD value in the match area varied a lot more than that of the mismatch area. (6) The lesion area in the MK and MD map and the MK and MD value positively correlated to the severity of ischemia evaluated by NHISS. (7) Fourteen cases were followed up with T2-FLAIR: ① Compared with the primitive MK map: ten cases showed almost the same lesion area, indicating good curative effect, 4 cases showed severely enlarged lesion area, indicating poor clinical outcome. ② Compared with the primitive MD map: ten cases showed smaller lesion area, indicating good curative effect, 2 cases showed the same lesion area, indicating stable clinical state, 2 cases showed significantly enlarged lesion area, indicating poor clinical outcome.Conclusions: DKI was able to differentiate infarct and ischemic area separately in ischemia, and it played an important role in detecting penumbra. Moreover, it could be used to evaluate the severity of ischemia and the curative effect if the patients were followed up with this technique in the long term.
[Keywords] Intracranial embolism and thrombosis；Acute disease；Magnetic resonance imaging

ZHANG Qin-cheng Department of Neurology, the Second Affiliated Hospital, Medical Academy of Shantou University, Shantou 515041, China

WANG Guang-wen Department of Neurology, Maoming People's Hospital of Guangdong Province, Maoming 525000, China

GUO Yue-lin Department of Medical Imaging, the Second Affiliated Hospital, Medical Academy of Shantou University, Shantou 515041, China

ZHENG Xiao-hong Department of Neurology, the Second Affiliated Hospital, Medical Academy of Shantou University, Shantou 515041, China

CHEN Wei* Department of Neurology, the Second Affiliated Hospital, Medical Academy of Shantou University, Shantou 515041, China

*Correspondence to: Chen W, E-mail: chw7203@126.com

Conflicts of interest   None.

Received  2017-03-12
Accepted  2017-06-06
DOI: 10.12015/issn.1674-8034.2017.07.002
DOI:10.12015/issn.1674-8034.2017.07.002.

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