Usefulness of diffusion-weighted MRl for thrombolytic therapy of acute cerebrai infarction

  • Deguchi Ichiro
    Department of Neurology and Cerebrovascular Medicine, Saitama Intemational Medical Center, Saitama Medical University
  • Uchino Akira
    Department of Diagnostic Radiology, Saitama IntemationaI MedicaI Center, Saitama MedicaI University
  • Nemoto Manabu
    Department of Emergency Medicine, Saitama Intemational Medical Center, Saitama MedicaI University
  • Tanahashi Norio
    Department of Neurology and Cerebrovascular Medicine, Saitama Intemational Medical Center, Saitama Medical University

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Other Title
  • 脳梗塞急性期血栓溶解療法における拡散強調MRI画像の有用性

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Since diffusion-weighted MRI (DWI) is able to detect a decrease in the diffusion of water molecules (Brownian motion) in ischemic brain tissue during the acute stage of cerebral infarction, it is able to depict acute-stage cerebral infarction as a high-intensity area within minutes. Thus, DWI is widely used to diagnose acute-stage cerebral infarction. Moreover, for selection of thrombolytic therapy for patients with acute-stage cerebral infarction, various new concepts employing DWI have been proposed. They include diffusion-perfusion mismatch (DPM), which combines perfusion images and DWI findings, clinical-diffusion mismatch (CDM), which combines the clinical severity and DWI findings, MRA-diffusion mismatch (MDM), which combines the MR angiography (MRA) findings for the presence or absence of main artery lesions and DWI findings, among others. The usefulness of DWI for selection of patients for acute-stage thrombolytic therapy has also been investigated. An overview of the usefulness of DWI, as well as DPM and MDM, which apply DWI findings, in acute-stage cerebral infarction patients is presented.

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