title: [Cerebral lesions of DWI hyperintensity in patients with subacute stroke assessed by intravoxel incoherent motion technique].
abstract: To investigate the cerebral lesions of diffusion weighted imaging (DWI) hyperintensity in patients with subacute stroke with intravoxel incoherent motion (IVIM) technique.
  
  
  
  The clinical data of 20 patients with ischemic stroke (3 to 7 d after onset) who underwent DWI and IVIM scanning between June 2014 and July 2015, were retrospectively analyzed. The parameters from IVIM including slow diffusion coefficient (D), fast diffusion coefficient (D(*)) and perfusion fraction (f) were processed. DWI hyperintensity was segmented by its signal intensity greater than the mean+2 standard deviations of the value in the homologous contralateral region. Then, DWI hyperintensity was classified into two regions of interest (ROIs): infarction core and peri-core with the ADC threshold of 0.55 × 10⁻³ mm²/s. The mirrored ROIs of infarction core and peri-core were also obtained. Then, we measured the values of ADC and D, D(*) and f in these ROIs. The ratios of ADC (rADC), D (rD), D(*) (rD(*)) and f (rf) were also calculated (e.g., rADC=ADCinfarction core/ADCmirrored region).
  
  
  
  Compared with mirrored region, ADC, D and f in the infarction core region decreased by 45% (P<0.001), 42% (P<0.001) and 32% (P<0.001), respectively; while ADC, D and f in the peri-core region decreased by 22% (P<0.001), 32% (P<0.001) and 8% (P=0.009), respectively. The values of rADC, rD, rD(*) and rf in the infarction core region were significantly lower than those in the peri-core region (all P<0.001). Pearson analysis showed that rADC was positively correlated with rf in the peri-core region (r=0.467, P=0.038).
  
  
  
  During subacute stage of stroke, compared to the infarction core region within DWI hyperintensity, D and f increase in the peri-core region of DWI hyperintensity, reflecting the increased water diffusion in microstructure and perfusion volume in microvasculature. This result shows that the potential reason for the heterogeneous ADC signal is associated with the disappearance of cellular edema and microvascular compensatory with increased blood volume.
authors.affiliation: Department of Radiology, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310009, China.
authors.forename: Rui-rui
authors.initials: RR
authors.lastname: Song
authors.affiliation: Department of Radiology, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310009, China.
authors.forename: Xin-feng
authors.initials: XF
authors.lastname: Yu
authors.affiliation: Department of Radiology, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310009, China.
authors.forename: Jiaerken
authors.initials: J
authors.lastname: Yerfan
authors.affiliation: Department of Radiology, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310009, China.
authors.forename: Jian-zhong
authors.initials: JZ
authors.lastname: Sun
authors.affiliation: Department of Neurology, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310009, China.
authors.forename: Ying-ying
authors.initials: YY
authors.lastname: Mao
authors.affiliation: Department of Neurology, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310009, China.
authors.forename: Yang
authors.initials: Y
authors.lastname: Guo
authors.affiliation: Department of Neurology, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310009, China.
authors.forename: Zhi-cai
authors.initials: ZC
authors.lastname: Chen
authors.affiliation: Department of Radiology, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310009, China.
authors.forename: Min-ming
authors.initials: MM
authors.lastname: Zhang
mesh_terms: D038524:Diffusion Magnetic Resonance Imaging; D006801:Humans; D009038:Motion; D012189:Retrospective Studies; D020521:Stroke / Q000175:diagnosis* / Q000473:pathology
references.citation: J Cereb Blood Flow Metab. 1994 Jul;14(4):620-7
references.pmid: 8014209
references.citation: Stroke. 2002 Jan;33(1):79-86
references.pmid: 11779893
references.citation: Neurology. 1997 Jul;49(1):113-9
references.pmid: 9222178
references.citation: AJNR Am J Neuroradiol. 1998 Jun-Jul;19(6):1061-6
references.pmid: 9672012
references.citation: Brain Behav. 2014;4(6):798-800
references.pmid: 25365795
references.citation: Magn Reson Med. 1993 Sep;30(3):318-25
references.pmid: 8412602
references.citation: Stroke. 2000 Jun;31(6):1311-7
references.pmid: 10835450
references.citation: Stroke. 2000 Aug;31(8):1965-72; discussion 1972-3
references.pmid: 10926965
references.citation: Stroke. 2015 Feb;46(2):441-6
references.pmid: 25503553
references.citation: Stroke. 2004 May;35(5):1095-9
references.pmid: 15060321
references.citation: Stroke. 1999 Nov;30(11):2382-90
references.pmid: 10548675
references.citation: Magn Reson Med. 2004 May;51(5):996-1001
references.pmid: 15122682
references.citation: Radiology. 1988 Aug;168(2):566-7
references.pmid: 3393682
references.citation: Stroke. 2000 Apr;31(4):946-54
references.pmid: 10754004
references.citation: Stroke. 2001 Aug;32(8):1897-905
references.pmid: 11486123
references.citation: J Cereb Blood Flow Metab. 1994 Mar;14(2):332-6
references.pmid: 8113328
references.citation: Radiology. 2001 Oct;221(1):27-34
references.pmid: 11568317
references.citation: Ann Neurol. 1995 Feb;37(2):231-41
references.pmid: 7847864
references.citation: Radiology. 2015 Feb;274(2):405-15
references.pmid: 25232802
references.citation: Acta Radiol. 1997 Nov;38(6):961-4
references.pmid: 9394649
references.citation: Eur Radiol. 2015 Jul;25(7):2049-58
references.pmid: 25576232
references.citation: J Magn Reson Imaging. 2000 Dec;12(6):842-58
references.pmid: 11105022
references.citation: Eur Radiol. 2015 Aug;25(8):2485-92
references.pmid: 25693668
references.citation: J Cereb Blood Flow Metab. 1995 Nov;15(6):1002-11
references.pmid: 7593332
references.citation: Radiology. 1988 Aug;168(2):497-505
references.pmid: 3393671