Increased anisotropy in acute stroke: a possible explanation.
OBJECTIVE
The increase in fractional anisotropy (FA) in acute stroke has yet to be explained. Using an engineering methodology known as pq diagrams, we sought to explain the increase in FA by describing changes in the total magnitude of the diffusion tensor (L) as well as the isotropic (p) and anisotropic (q) components.


METHODS
Diffusion tensor imaging was performed in 10 patients with stroke <27 hours old. The diffusion tensor was decomposed into the p and q components and plotted to describe the diffusion trajectories. FA was also calculated and compared.


RESULTS
There was significant and consistent reduction in p, q, and L (p: mean, -50.0%; range, -36.6% to -64.5%; q: mean, -50.8%; range, -30.8% to -72.8%; L: mean, -50.3%; range, -37.0% to -65.1%). There were inconsistent changes in FA (mean, -0.5%; range, -44.9% to +45.0%). Five patients had elevated FA due to proportionately higher loss of L than q.


CONCLUSIONS
Changes in FA only occur when there is a change in the ratio of q/L. Acute elevation of FA occurred in the context of a larger reduction in L than q. The elevation in FA occurs in the context of a reduction in the anisotropic tensor and therefore is a consequence of ratio-metric measurement. This appears to clarify the reported increase in FA in terms of alterations in the shape of the apparent diffusion tensor. pq diagrams appear to offer improved resolution of acute diffusion changes in ischemia.
Green
Hadrian A L
HA
Department of Neurosurgery, Addenbrooke's Hospital and the University of Cambridge, Cambridge, UK. halg2@wbic.cam.ac.uk
Peña
Alonso
A
Price
Christopher J
CJ
Warburton
Elizabeth A
EA
Pickard
John D
JD
Carpenter
T Adrian
TA
Gillard
Jonathan H
JH
D000368:Aged; D016880:Anisotropy; D001834:Body Water / Q000378:metabolism; D001921:Brain / Q000378:metabolism; D015331:Cohort Studies; D004058:Diffusion; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008962:Models, Theoretical; D020521:Stroke / Q000175:diagnosis* / Q000378:metabolism; D013997:Time Factors