Prediction of prognosis of infarct by analyzing apparent diffusion coefficient measurements in acute ischemic stroke without intravenous contrast material

Objective: To investigate whether quantitative apparent diffusion coefficient(ADC) measurements can be employed to predict the prognosis of infarction in acute ischemic stroke without intravenous contrast material.Methods: Thirty-three patients having acute stroke symptoms with verified infarction in magnetic resonance imaging(MRI) were included in this study.Their MRI studies were performed between 6 and 12 h after the onset of their symptoms and were repeated.The infarction volumes were calculated by using DWI and the patients were divided into two groups as the ones having an expansion in the infarction area(group I,n=22) and the others having no expansion in the infarction area(group II,n=11).The groups were compared in terms of the ADC values and areas obtained from DWI,referring to three points: the core of the infarction,ischemic penumbra and the contralateral nonischemic parenchymal tissue.Quantitative ADC values and the infarction area were estimated.P 0.05 were accepted to be statistically significant.Results: The internal mean infarction area during the times between 6 and 12 h and in the fourth day was calculated by DWI.A significant statistical result was demonstrated on the DWI between the two groups(P0.001) and there was no difference between the core of the infarction and parenchymal tissue(P0.05).The ADC values of ischemic penumbra between the groups were found to be highly significant(P0.001).Conclusion: We believe that ADC results obtained from the core and the penumbra of the infarction area without intravenous contrast material will be a feasible and practical in the estimation of the infarction prognosis and in the planning of a treatment protocol.