The Role of Quantitative Neuroimaging Indices in the Differentiation of Ischemia From Demyelination: An Analytical Study With Case Presentation

摘要: Background and purpose: Differentiation of acute subacute ischemic stroke lesions from demyelinating multiple sclerosis (MS) may not be possible on conventional magnetic resonance imaging (MRI). Both lesion types enhance T1 with gadolinium (Gd) contrast both are hyperintense diffusion‐weighted (DWI). This study is an analysis two quantitative MR indices: (1) calculated apparent diffusion coefficients (ADCs) (2) T2 relaxation times (T2R) as means toward differentiating lesions. Chronic were evaluated for comparison well. Methods: The MRI nine patients chronic six analyzed ADC T2Rs. indices measured by manually placing regions interest (ROIs) at the anatomic center lesion. Acute chosen their hyperintensity DWI hypointensity mapping. selected peripheral enhancement after administration Gd. Computation involved coefficient a region basis follows: D = −(b0/b1000)ln(Sb1000/Sb0), where Sb1000 signal intensity Sb0 sensitivities b0 b1000, respectively. T2R was made (TET2 − TEPD)/(ln SIPD ln SIT2), TE echo time different pulse sequences, SI PD represents proton density sequence. Results: Twenty‐nine ischemia, 27 demyelination, 28 43 demyelination image sets analyzed. differences between ADCacute infarct (0.760) versus plaque (1.106) significant (p Conclusions: in combination useful tool to differentiate use these neuroimaging along spectroscopy metabolite ratios then demonstrated elucidating pathophysiological mechanism case delayed posttraumatic bilateral internuclear ophthalmoplegia.