Clinical applications of diffusion weighted imaging in neuroradiology

Drake-Pérez, Marta; Boto, José; Fitsiori, Aikaterini; Lövblad, Karl-Olof; Vargas, María Isabel

doi:10.1007/s13244-018-0624-3

Cited by 114 publications

(87 citation statements)

References 79 publications

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“…In acute brain parenchymal ischaemia following vascular thrombo-occlusion, failure of sodium-potassium adenosine triphosphate (ATP)-dependent (Na + /K + -ATPase) pumps forms the premise of cytotoxic oedema or accumulation of water within neurons. The lack of transmembrane motion of water, in other words 'restriction' of their random Brownian motion, causes hyperintense signal on DWI and hypointense signal on apparent diffusion coefficient (ADC) images [1][2][3]. These changes initially affect the grey matter due to its high metabolic activity and high astrocyte density [2].…”

Section: Introductionmentioning

confidence: 99%

Gyriform restricted diffusion in adults: looking beyond thrombo-occlusions

2020

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Gyriform restricted diffusion (GRD) refers to hyperintense signal involving the cerebral cortex on diffusion-weighted images (DWI) with corresponding hypointensity on apparent diffusion coefficient (ADC) images. These changes are commonly seen following a vascular occlusion, reflecting the limitation of water molecule movement across cell membranes (restricted diffusion) due to the failure of Na + /K + -ATPase pumps (cytotoxic oedema). However, GRD can occur in several other neurological conditions as well. A thorough understanding of these conditions and their anatomic predilection plays a critical role in identifying and differentiating them from vascular thrombo-occlusion, with impact towards appropriate clinical management. This review highlights the less commonly encountered, non-stroke causes of GRD in adults with case-based examples. A tabulated chart of the patterns of cortical and subcortical involvement associated with these aetiologies is provided for a quick, pattern-based reference for daily radiological reporting.

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Section: Introductionmentioning

confidence: 99%

Gyriform restricted diffusion in adults: looking beyond thrombo-occlusions

2020

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“…In future, we plan to evaluate at later time points to determine whether baseline values are fully recoverable. ADC is a classic parameter used to evaluate the water diffusivity of tissue, related to the cellularity, cytotoxic edema, and angiogenic edema [27]. The decline of ADC means restriction of water molecule diffusion.…”

Section: Discussionmentioning

confidence: 99%

Temporal lobe microstructural abnormalities in patients with nasopharyngeal carcinoma quantitatively evaluated by high-resolution DWI and DKI after concurrent chemoradiotherapy

Balasubramanian

et al. 2020

Clinical and Translational Radiation Oncology

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To investigate temporal lobe microstructural abnormalities and neurocognitive function impairment after concurrent chemoradiotherapy (CCRT) in patients with nasopharyngeal carcinoma (NPC). Methods: NPC patients who underwent CCRT were enrolled. High-resolution diffusion-weighted imaging (DWI) magnetic resonance imaging (MRI) and diffusion-kurtosis imaging (DKI) MRI, were performed 5 times per patient (once pre-CCRT, 1 week post-CCRT, 3 months post-CCRT, 6 months post-CCRT, and 12 months post-CCRT). Neurocognitive function was evaluated by Montreal Neurocognitive Assessment (MoCA) twice per patient, once pre-CCRT, and once 12-months after CCRT. Results: Of 111 patients, 56 completed the entire protocol. The MRI derived apparent diffusion coefficient (ADC), mean of diffusion coefficient (Dmean) and fractional anisotropy (FA) values were significantly decreased (p < 0.05) over the 0-3 month period following CCRT and significantly increased (p < 0.05) over the 3-12 month period following CCRT. The mean of kurtosis coefficient (Kmean) continued to decline over a year post-CCRT. All parameters reveal more pronounced changes in white matter (WM) than in grey matter (GM). MoCA also declined after CCRT (p < 0.001). MoCA showed significant positive correlation with Kmean-WM-6 m, Kmean-WM-12 m and DKmean-WM. Conclusions: High-resolution DWI and DKI should be considered as a promising method for the investigation of temporal lobe microstructural change in NPC patients after CCRT.

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“…Over the last decade, DW-MRI of the spine has proven its value and has been successfully employed in many clinical situations [9]. In the present study, 100 patients with 302 vertebral lesions were recruited.…”

Section: Discussionmentioning

confidence: 99%

Role of diffusion-weighted magnetic resonance imaging in the evaluation of vertebral bone marrow lesions

Kaur¹,

Thukral²,

Khanna³

et al. 2020

Pol J Radiol

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Purpose: To evaluate the role of diffusion-weighted magnetic resonance imaging (DW-MRI) in differentiating vertebral marrow pathologies. To determine the sensitivity, specificity, and threshold apparent diffusion coefficient (ADC) values that can aid in the differentiation of malignant from benign bone marrow lesions. Material and methods: This observational study included 100 patients, who underwent MRI examination with a 1.5 Tesla scanner. The ADC values of normal and pathological vertebrae were estimated, and the threshold ADC values were computed by receiver operating characteristic (ROC) analysis. The results were correlated with histopathological diagnosis, clinical follow-up, and other investigations. Statistical analysis was done by employing unpaired two-tailed Student's t-test and the p-value of < 0.05 was deemed as statistically significant. Results: Vertebral bone marrow lesions had a male predominance and there was a predilection towards thoracic and lumbar vertebrae, with L4 being the commonest. Metastasis was the commonest lesion, followed by spondylodiscitis. The mean ADC value of benign pathologies was significantly greater than malignant pathologies (p < 0.05). The threshold value for the demarcation between benign and malignant pathologies was computed to be 1.21 × 10-3 mm 2 /s. DW imaging had sensitivity of 100%, specificity of 92.31%, positive predictive value of 87.5%, and negative predictive value of 100%. Conclusions: Vertebral marrow lesions can be differentiated as benign or malignant with good sensitivity and specificity with the help of DW-ADC maps.

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Clinical applications of diffusion weighted imaging in neuroradiology

Cited by 114 publications

References 79 publications

Gyriform restricted diffusion in adults: looking beyond thrombo-occlusions

Gyriform restricted diffusion in adults: looking beyond thrombo-occlusions

Temporal lobe microstructural abnormalities in patients with nasopharyngeal carcinoma quantitatively evaluated by high-resolution DWI and DKI after concurrent chemoradiotherapy

Role of diffusion-weighted magnetic resonance imaging in the evaluation of vertebral bone marrow lesions

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