Early cerebral infarction: gadopentetate dimeglumine enhancement.
Gadopentetate dimeglumine was administered prospectively to 50 patients who presented for magnetic resonance (MR) imaging within 2 weeks after a cortical cerebral infarction. Twenty-two patients (44%) were imaged within 3 days after clinical ictus. Abnormalities detected with gadopentetate dimeglumine enhancement were observed in 46 (92%) of 50 patients. Classic parenchymal enhancement was a late finding, observed in all patients (17 of 17) imaged at 7-14 days after infarction. Before this time, three additional phases of contrast material-related abnormalities were observed. Enhancement of vessels supplying the infarct ("intravascular enhancement sign") was the earliest finding, seen in 17 (77%) of 22 infarcts aged 1-3 days. From day 2 to day 6, abnormal enhancement of meninges adjacent to the infarct was frequently noted ("meningeal enhancement sign"). Finally, a transition phase that combined intravascular or meningeal enhancement with early parenchymal enhancement was seen from day 3 to day 6. Gadopentetate dimeglumine-enhanced MR imaging in early stroke reveals evidence of vascular engorgement and sluggish flow, which precede the development of classic parenchymal enhancement.
Elster
A D
AD
Department of Radiology, Bowman Gray School of Medicine, Wake Forest University, Winston-Salem, NC 27103.
Moody
D M
DM
D001921:Brain / Q000473:pathology*; D002544:Cerebral Infarction / Q000175:diagnosis*; D002560:Cerebrovascular Circulation / Q000502:physiology; D003287:Contrast Media; D005260:Female; D005682:Gadolinium; D019786:Gadolinium DTPA; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009942:Organometallic Compounds; D004369:Pentetic Acid; D013997:Time Factors
D003287:Contrast Media; D009942:Organometallic Compounds; D004369:Pentetic Acid; D005682:Gadolinium; D019786:Gadolinium DTPA