Korean Journal of Radiology

The Korean Society of Radiology (대한영상의학회)
권호 표지
DOI QR코드

DOI QR Code

Transient Ischemic Attack and Stroke Can Be Differentiated by Analyzing the Diffusion Tensor Imaging

  • Tong, Tong (Department of Radiology, Fudan University Shanghai Cancer Center, The Department of Oncology, Shanghai Medical College, Fudan University) ;
  • Zhenwei, Yao (Department of Radiology, Huashan Hospital, Shanghai Medical College, Fudan University) ;
  • Xiaoyuan, Feng (Department of Radiology, Huashan Hospital, Shanghai Medical College, Fudan University)
  • Published : 2011.06.01
⟨ Previous Next ⟩

Abstract

Objective: We wanted to differentiate between transient ischemic attack (TIA) and minor stroke using fractional anisotropy and three-dimensional (3D) fiber tractography. Materials and Methods: The clinical data, conventional magnetic resonance imaging (MRI), diffusion weighted imaging (DWI) and diffusion tensor imaging (DTI) were obtained for 45 TIA patients and 33 minor stroke patients. The fractional anisotrophy ratio (rFA) between the lesion and the mirrored corresponding contralateral normal tissue was calculated and analyzed. The spatial relationship between the lesion and the corticospinal tract (CST) was analyzed and the lesion sizes in the minor stroke patients and TIA patients were compared. Results: Twenty-two of the 45 TIA patients (49%) revealed focal abnormalities following DWI. The rFA was significantly lower (p < 0.05) in the stroke patients (0.71 ${\pm}$ 0.29) compared to that of the TIA patients (1.05 ${\pm}$ 0.37). The CST was involved in almost all stroke lesions, but it was not involved in 68% of the TIA lesions. The TIA patients had significantly lower CST injury scores (3.25 ${\pm}$ 1.75) than did the stroke patients (8.80 ${\pm}$ 2.39) (p = 0.004). Conclusion: Our data indicate that TIA and minor stroke can be identified by analyzing the rFA and the degree of CST involvement, and this may also allow more accurate prediction of a patient's long-term recovery or disability.

Keywords

References

  1. Mukherjee P, Berman JI, Chung SW, Hess CP, Henry RG. Diffusion tensor MR imaging and fiber tractography: theoretic underpinnings. AJNR Am J Neuroradiol 2008;29:632-641 https://doi.org/10.3174/ajnr.A1051
  2. Mukherjee P, Chung SW, Berman JI, Hess CP, Henry RG. Diffusion tensor MR imaging and fiber tractography: technical considerations. AJNR Am J Neuroradiol 2008;29:843-852 https://doi.org/10.3174/ajnr.A1052
  3. Pierpaoli C, Barnett A, Pajevic S, Chen R, Penix LR, Virta A, et al. Water diffusion changes in Wallerian degeneration and their dependence on white matter architecture. Neuroimage 2001;13:1174-1185
  4. Virta A, Barnett A, Pierpaoli C. Visualizing and characterizing white matter fiber structure and architecture in the human pyramidal tract using diffusion tensor MRI. Magn Reson Imaging 1999;17:1121-1133 https://doi.org/10.1016/S0730-725X(99)00048-X
  5. Thomalla G, Glauche V, Koch MA, Beaulieu C, Weiller C, Rother J. Diffusion tensor imaging detects early Wallerian degeneration of the pyramidal tract after ischemic stroke. Neuroimage 2004;22:1767-1774 https://doi.org/10.1016/j.neuroimage.2004.03.041
  6. Ahlhelm F, Reith W. Modern diagnosis in acute cerebral infarct. Diffusion weighted imaging and ADC (apparent diffusion coefficient) calculations. Nervenarzt 2002;73:736-744 https://doi.org/10.1007/s00115-002-1338-8
  7. Crisostomo RA, Garcia MM, Tong DC. Detection of diffusionweighted MRI abnormalities in patients with transient ischemic attack: correlation with clinical characteristics. Stroke 2003;34:932-937 https://doi.org/10.1161/01.STR.0000061496.00669.5E
  8. Kidwell CS, Alger JR, Di Salle F, Starkman S, Villablanca P, Bentson J, et al. Diffusion MRI in patients with transient ischemic attacks. Stroke 1999;30:1174-1180 https://doi.org/10.1161/01.STR.30.6.1174
  9. Ay H, Oliveira-Filho J, Buonanno FS, Schaefer PW, Furie KL, Chang YC, et al. 'Footprints' of transient ischemic attacks: a diffusion-weighted MRI study. Cerebrovasc Dis 2002;14:177-186 https://doi.org/10.1159/000065682
  10. Marx JJ, Mika-Gruettner A, Thoemke F, Fitzek S, Fitzek C, Vucurevic G, et al. Diffusion weighted magnetic resonance imaging in the diagnosis of reversible ischaemic deficits of the brainstem. J Neurol Neurosurg Psychiatry 2002;72:572-575 https://doi.org/10.1136/jnnp.72.5.572
  11. Kastrup A, Schulz JB, Mader I, Dichgans J, Kuker W. Diffusionweighted MRI in patients with symptomatic internal carotid artery disease. J Neurol 2002;249:1168-1174 https://doi.org/10.1007/s00415-002-0793-2
  12. Rovira A, Rovira-Gols A, Pedraza S, Grive E, Molina C, Alvarez-Sabin J. Diffusion-weighted MR imaging in the acute phase of transient ischemic attacks. AJNR Am J Neuroradiol 2002;23:77-83
  13. Lecouvet FE, Duprez TP, Raymackers JM, Peeters A, Cosnard G. Resolution of early diffusion-weighted and FLAIR MRI abnormalities in a patient with TIA. Neurology 1999;52:1085-1087 https://doi.org/10.1212/WNL.52.5.1085
  14. Winbeck K, Bruckmaier K, Etgen T, von Einsiedel HG, Rottinger M, Sander D. Transient ischemic attack and stroke can be differentiated by analyzing early diffusion-weighted imaging signal intensity changes. Stroke 2004;35:1095-1099 https://doi.org/10.1161/01.STR.0000125720.02983.fe
  15. Faraggi D, Reiser B. Estimation of the area under the ROC curve. Stat Med 2002;21:3093-3106 https://doi.org/10.1002/sim.1228
  16. Nagai Y, Kitagawa K, Yamagami H, Kondo K, Hougaku H, Hori M, et al. Carotid artery intima-media thickness and plaque score for the risk assessment of stroke subtypes. Ultrasound Med Biol 2002;28:1239-1243 https://doi.org/10.1016/S0301-5629(02)00573-2
  17. Sorensen AG, Wu O, Copen WA, Davis TL, Gonzalez RG, Koroshetz WJ, et al. Human acute cerebral ischemia: detection of changes in water diffusion anisotropy by using MR imaging. Radiology 1999;212:785-792 https://doi.org/10.1148/radiology.212.3.r99se24785
  18. Zelaya F, Flood N, Chalk JB, Wang D, Doddrell DM, Strugnell W, et al. An evaluation of the time dependence of the anisotropy of the water diffusion tensor in acute human ischemia. Magn Reson Imaging 1999;17:331-348 https://doi.org/10.1016/S0730-725X(98)00192-1
  19. Duong TQ, Ackerman JJ, Ying HS, Neil JJ. Evaluation of extra-and intracellular apparent diffusion in normal and globally ischemic rat brain via 19F NMR. Magn Reson Med 1998;40:1-13 https://doi.org/10.1002/mrm.1910400102
  20. Yamada K, Mori S, Nakamura H, Ito H, Kizu O, Shiga K, et al. Fiber-tracking method reveals sensorimotor pathway involvement in stroke patients. Stroke 2003;34:E159-E162 https://doi.org/10.1161/01.STR.0000085827.54986.89
  21. Easton JD, Saver JL, Albers GW, Alberts MJ, Chaturvedi S, Feldmann E, et al. Definition and evaluation of transient ischemic attack: a scientific statement for healthcare professionals from the American Heart Association/American Stroke Association Stroke Council; Council on Cardiovascular Surgery and Anesthesia; Council on Cardiovascular Radiology and Intervention; Council on Cardiovascular Nursing; and the Interdisciplinary Council on Peripheral Vascular Disease. The American Academy of Neurology affirms the value of this statement as an educational tool for neurologists. Stroke 2009;40:2276-2293 https://doi.org/10.1161/STROKEAHA.108.192218
  22. Tong T, Yao Z, Feng X. Combined diffusion- and perfusion-weighted imaging: a new way for the assessment of hemispheric transient ischemic attack patients. Int J Dev Neurosci 2011;29:63-69 https://doi.org/10.1016/j.ijdevneu.2010.09.002

Cited by

  1. Serial MR Analysis of Early Permanent and Transient Ischemia in Rats: Diffusion Tensor Imaging and High b Value Diffusion Weighted Imaging vol.14, pp.2, 2011, https://doi.org/10.3348/kjr.2013.14.2.307
  2. Enhanced Interhemispheric Functional Connectivity Compensates for Anatomical Connection Damages in Subcortical Stroke vol.46, pp.4, 2011, https://doi.org/10.1161/strokeaha.114.007044
  3. Does the Reporting Quality of Diagnostic Test Accuracy Studies, as Defined by STARD 2015, Affect Citation? vol.17, pp.5, 2016, https://doi.org/10.3348/kjr.2016.17.5.706
  4. Prediction of Upper Limb Motor Recovery after Subacute Ischemic Stroke Using Diffusion Tensor Imaging: A Systematic Review and Meta-Analysis vol.18, pp.1, 2011, https://doi.org/10.5853/jos.2015.01186
  5. Comparison of 3- and 20-Gradient Direction Diffusion-Weighted Imaging in a Clinical Subacute Cohort of Patients with Transient Ischemic Attack: Application of Standard Vendor Protocols for Lesion Dete vol.8, pp.None, 2011, https://doi.org/10.3389/fneur.2017.00691
  6. Changes to white matter microstructure in transient ischemic attack: A longitudinal diffusion tensor imaging study vol.38, pp.11, 2017, https://doi.org/10.1002/hbm.23768