Diffusion Measurements in the Ischemic Human Brain with a Steady-State Sequence

Abstract

RATIONALE AND OBJECTIVES The authors evaluate the clinical usefulness of a diffusion-weighted steady-state free-precession (SSFP) sequence to detect acute and subacute ischemic changes. METHODS Twenty-four patients were patients examined on a 1.5-tesla scanner, using a SSFP-sequence (repetition time [TR]/echo time [TE] = 22/3-8 mseconds). The slice thickness was 5 mm, 10 averages, 57 seconds per slice. The diffusion gradient strength was 23 millitesla/m, with b-values from 165 to 598 seconds/mm². Diffusion-weighted images (DWI) were compared with T2-weighted images. RESULTS The diffusion-weighted SSFP sequence produced diagnostic quality images in 23 of 24 patients. Diffusion depicted (group 1: 0-12 hours) more acute lesions (3 of 6) than T2-weighted images (2 of 6); the mean lesion diameter depicted by diffusion was 10.9 mm (standard deviation [SD], 12.3) and in T2-weighted images was 4.7 mm (SD 6.8). A significant correlation (P < 0.017) in subacute lesions was found when diffusion was compared with turbo spin echo (mean size difference/T2 = 18.5/17.5 mm, SD 13.2/12.2). CONCLUSIONS The diffusion-weighted SSFP-sequence is more sensitive in acute ischemia and delineates likewise in subacute ischemia, when compared with T2-weighted imaging.