title: Effect of Intravenous Thrombolysis on the Time Course of the Apparent Diffusion Coefficient in Acute Middle Cerebral Artery Infarction.
abstract: OBJECTIVE
  To examine the possible effects of intravenous thrombolysis on the time course of the apparent diffusion coefficient in the patients with acute middle cerebral artery infarct.
  
  
  METHODS
  Serial MRI data with all in all 190 MR examinations including diffusion-weighted imaging (DWI), apparent diffusion coefficient map (ADC map) and T2 -weighted imaging (T2 w) of 74 patients with initial intravenous thrombolysis (study group; N = 37) or conservative stroke treatment (control group; N = 37) were retrospectively analyzed. A trend function was fitted to the relative values (rADC, rDWI, rT2 w) to model an objective, general time course.
  
  
  RESULTS
  Relative apparent diffusion coefficient (rADC) decreased in both groups to a minimum about 15 hours after symptom onset. Afterwards rADC increased faster in the study group and reached pseudonormalization 5 ± 2 days after symptom onset. In the control group pseudonormalization was determined later at 7 ± 6 days after symptom onset. After pseudonormalization rADC continued to increase in both groups.
  
  
  CONCLUSIONS
  rADC pseudonormalization occurred by trend earlier in the study group. Therefore, intravenous thrombolysis seems to have an effect on the time course of ADC, which is likely to be due to earlier cerebral reperfusion after thrombolysis. In addition, initial stroke treatment as thrombolysis should be considered in radiological rating of stroke MRI time course.
authors.affiliation: Hans Berger Department of Neurology, Jena University Hospital, Jena, Germany.
authors.forename: Lydia
authors.initials: L
authors.lastname: Kretzer
authors.affiliation: Institute of Neuroscience and Medicine (INM-1), Research Centre Jülich, Jülich, Germany.
authors.forename: David
authors.initials: D
authors.lastname: Gräßel
authors.affiliation: Department of Neuroradiology, Jena University Hospital, Jena, Germany.
authors.forename: Martin A
authors.initials: MA
authors.lastname: Bokemeyer
authors.affiliation: Hans Berger Department of Neurology, Jena University Hospital, Jena, Germany.
authors.forename: Albrecht
authors.initials: A
authors.lastname: Günther
authors.affiliation: Hans Berger Department of Neurology, Jena University Hospital, Jena, Germany.|Center for Sepsis Control and Care (CSCC), Jena University Hospital, Germany.
authors.forename: Otto W
authors.initials: OW
authors.lastname: Witte
authors.affiliation: Hans Berger Department of Neurology, Jena University Hospital, Jena, Germany.|Center for Sepsis Control and Care (CSCC), Jena University Hospital, Germany.
authors.forename: Hubertus
authors.initials: H
authors.lastname: Axer
authors.affiliation: Hans Berger Department of Neurology, Jena University Hospital, Jena, Germany.
authors.forename: Thomas M
authors.initials: TM
authors.lastname: Ringer
mesh_terms: D000328:Adult; D000368:Aged; D038524:Diffusion Magnetic Resonance Imaging; D005260:Female; D005343:Fibrinolytic Agents / Q000627:therapeutic use*; D006801:Humans; D020244:Infarction, Middle Cerebral Artery / Q000000981:diagnostic imaging / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D020521:Stroke / Q000000981:diagnostic imaging / Q000188:drug therapy*; D015912:Thrombolytic Therapy / Q000379:methods*; D010959:Tissue Plasminogen Activator / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D005343:Fibrinolytic Agents; D010959:Tissue Plasminogen Activator
keywords: Acute middle cerebral artery infarct; apparent diffusion coefficient; diffusion-weighted imaging; intravenous thrombolysis; pseudonormalization