Stratification of Heterogeneous Diffusion MRI Ischemic Lesion With Kurtosis Imaging Evaluation of Mean Diffusion and Kurtosis MRI Mismatch in an Animal Model of Transient Focal Ischemia

Harvard University, Cambridge, Massachusetts, United States
Stroke (Impact Factor: 6.02). 07/2012; 43(8):2252-4. DOI: 10.1161/STROKEAHA.112.661926
Source: PubMed

ABSTRACT Ischemic tissue damage is heterogeneous, resulting in complex patterns in the widely used diffusion-weighted MRI. Our study examined the spatiotemporal characteristics of diffusion kurtosis imaging in an animal model of transient middle cerebral artery occlusion.
Adult male Wistar rats (N=18) were subjected to 90 minutes middle cerebral artery occlusion. Multiparametric MR images were obtained during middle cerebral artery occlusion and 20 minutes after reperfusion with diffusion-weighted MRI obtained using 8 b-values from 250 to 3000 s/mm(2) in 6 diffusion gradient directions. Diffusion and kurtosis lesions were outlined in shuffled images by 2 investigators independently. T(2) MRI was obtained 24 hours after middle cerebral artery occlusion to evaluate stroke outcome.
Mean diffusion lesion (23.5%±8.1%, percentage of the brain slice) was significantly larger than mean kurtosis lesion (13.2%±2.0%) during middle cerebral artery occlusion. Mean diffusion lesion decreased significantly after reperfusion (13.8%±4.3%), whereas mean kurtosis lesion showed little change (13.0%±2.5%) with their lesion size difference being insignificant.
We demonstrated that mean diffusion/mean kurtosis mismatch recovered reasonably well on reperfusion, whereas regions with concurrent mean diffusion and mean kurtosis deficits showed poor recovery. Diffusion kurtosis imaging may help stratify heterogeneous diffusion-weighted MRI lesions for enhanced characterization of ischemic tissue injury.

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    • "Furthermore, studies on brain maturation (Cheung et al., 2009), temporal lobe epilepsy (Gao et al., 2012) and stroke lesion visualization (Grinberg et al., 2012) have reported the enhanced sensitivity of DKI parameters over DTI parameters in discerning differences in tissue status. In other studies (Blockx et al., 2012; Cheung et al., 2012; Grossman et al., 2012), a combined use of kurtosis and DTI parameters proved to be advantageous in detecting tissue changes. These observations indicate that kurtosis parameters can discriminate healthy from abnormal tissue under various pathophysiological conditions. "
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