Diffusion-weighted Imaging and Arterial Spin Labeling for Prediction of Cerebral Infarct Volume in Acute Atherothrombotic Stroke

Objectives: This study aims to investigate the usefulness of diffusion-weighted imaging (DWI) and arterial spin labeling (ASL) for predicting final infarct volume in patients with acute atherothrombotic subtype cerebral infarction (AT-type stroke). Methods: The data of 77 patients with AT-type stroke were retrospectively analyzed. ASL and DWI values of minimum apparent diffusion coefficient (min ADC), mean ADC (mean ADC), minimum cerebral blood flow (min CBF), and mean CBF (mean CBF) of the infarction lesions were measured. Changes in cerebral infarction volume (Delta Volume) were determined by DWI reexamination on the 7(th) day after onset. Correlations of ADC and CBF with Delta Volume were analyzed. Receiver operating characteristic (ROC) curve analysis was used to determine the usefulness of ADC and CBF values for predicting final infarct volume. Results: here was a significant difference in the distribution of the Delta Volume in AT-type stroke (P<0.0001). The ADC and min CBF values were negatively correlated with the infarct Delta Volume (P<0.05); mean CBF and Delta CBF were not correlated with Delta Volume. When min ADC was <= 0.303 x 10(-3) mm(2)/s, min CBF 1.5 <= 2.415 mL/100 g/min, or min CBF2.5 <= 4.25 mL/100 g/min, Delta Volume was likely to be large. The ROC curve showed the highest predictive value for min ADC and min CBF. Conclusion: Distinctive patterns of quantitative ADC and CBF can be used as a simple and rapid method for predicting change in infarction volume in AT-type stroke.