Apparent diffusion coefficient value for prediction of hemorrhagic transformation in acute ischemic infarction

Objective: We investigated the role of apparent diffusion coefficient (ADC) values in assessing the risk of hemorrhagic transformation in acute cerebral infarcts. Materials and methods: Fifty-eight patients with acute ischemic infarction undergoing magnetic resonance (MR) examinations, including diffusion-weighted imaging (DWI) and susceptibility weighted imaging (SWI), were included. Repeat MR examinations were performed within two weeks after admission. Patients were divided into hemorrhagic transformation (HT) group and non-HT group. The minimum and mean ADC values of the cerebral infarct areas were measured on the initial DWI. Between-group differences in ADC values were assessed using two-sample t-test. Results: Twenty-eight (48.3%) patients had developed HT, while no evidence of HT was observed in 30 (51.7%) patients. Patients with HT had lower minimum and mean ADC values (P < 0.05 vs. non-HT group). The optimal cut-off level of minimum ADC value for predicting HT was 450 x 10(-6) mm(2)/ s, and that of mean ADC value was 500 x 10(-6) mm(2)/ s. Conclusion: Change in signal intensity on the ADC map and quantitative analysis of the ADC values may help predict hemorrhagic transformation in patients with early ischemic infarction.