Diffusion weighted magnetic resonance imaging of compromised tissue in stroke
a Institute of Child Health,
University College London Medical School, London : Radiology
and Physics Unit, b Neurosciences Unit, c Great Ormond Street Hospital for Children NHS
Trust, London: Department of Radiology
Correspondence to: Dr Alan Connelly, MR2, Department of Radiology, Great Ormond Street Hospital for Children, London WC1N 3JH.
Accepted 23 April 1997
Diffusion weighted imaging (DWI) and T2 weighted magnetic
resonance imaging were performed on at least two occasions in 28 children presenting with stroke. In previous reports of DWI in human
stroke, eventual infarction was observed (with only one exception) in
all regions in which early DWI hyperintensity occurred. In the present
report, two children had regions of DWI hyperintensity which did not
progress to infarction. One patient who presented with right hemiplegia
showed extensive high signal on DWI, with T2 evidence of tissue
swelling but without hyperintensity. DWI changes persisted over weeks,
with no imaging indication of infarction. This child recovered
completely. A second child who had a major vessel infarct with
concomitant regions of hyperintensity on T2 weighted imaging and DWI,
also had DWI hyperintensity in an adjacent territory which did not
develop any subsequent evidence of infarction. Thus in clinical
practice DWI can demonstrate tissue which is compromised but not
irreversibly so.
© 1997 by Archives of Disease in Childhood
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