From the Department of Neuropathology, Medical Research Institute (T.K.);
and Departments of Neurosurgery (T.N., H.A.); Anesthesiology (M.U.); Radiology
(I.Y.); and Gynecology and Obstetrics (N.M.), Tokyo Medical and Dental
University (Japan).
Background and Purpose—Early and
accurate diagnosis of brain edema in stroke patients is essential for
the selection of appropriate treatment. We examined the correlations
between the changes in the apparent diffusion coefficient (ADC),
regional water content, and tissue ultrastructure during early focal
cerebral ischemia.
Methods—The left middle cerebral arteries of cats were occluded
with an intramagnet occlusion/recirculation device. T2-weighted,
diffusion-weighted, and perfusion imaging were performed repeatedly
during the initial 3 hours after occlusion. The ADCs obtained from ADC
maps were compared with the corresponding tissue water content values
determined by gravimetry and electron microscopic water
localization.
Results—ADC reduction was detected in areas of low perfusion 15
minutes after occlusion and thereafter. The water content increase
correlated linearly with the ADC decreases in both the gray and white
matter. However, both the water content corresponding to an ADC value
and the rate of ADC change of the gray and white matter differed
significantly (P<.05) as follows: y
=-10105x+8533 (r=.86) and
y=-6174x+4611 (r=.67),
respectively, where x is the water content (grams water
per gram tissue) and y is the ADC
(x10-6 mm2/s). Hydropic astrocytic
swelling was seen in both structures, and in the white matter,
oligodendroglial and myelinated axonal swelling and
periaxonal space enlargement were observed.
Conclusions—When early ischemic edema in experimental
focal cerebral ischemia is evaluated with ADC mapping, the
different slopes and intercepts of the water content and ADC
correlation lines for the gray and white matter, which probably reflect
different ultrastructural localization of water, should be taken into
account.
Department
Internal Medicine Cardiovascular
Division University of Iowa College of Medicine Iowa City,
Iowa
© 1998 American Heart Association, Inc.
Original Contributions
Different Apparent Diffusion Coefficient
Water Content Correlations of Gray and White Matter During Early Ischemia
Editorial Comment
Water Content Correlations of Gray and White Matter During Early Ischemia
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