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Transcript 
Comparing b1000 and b 2000 Diffusion Imaging
in Acute Stroke at 3T MRI
A David, C Billon-Grand, B Ibanez, F Cattin, JF Bonneville
Jean Minjoz Hospital
Besançon, France
Purpose


Analysing and comparing b 1000 and b 2000 diffusionweighted in early stroke
Comparison of diffusion imaging sensitivity at different
b values
Patients and methods

68 patients (aged 41-81-yr-old) with suspected stroke
in the first 6 hours of neurological deficit

Follow-up MRI at 30 days (FLAIR sequence included)

11 month-period
.
MRI protocol






3T General Electric Signa Excite
b1000 et b2000 diffusion
FLAIR
T2*
TOF MRA of Willis circle
EPI diffusion imaging : TR/TE 7000/88 in b1000
7000/103 in b2000
5.0 thk/1.5 sp; 22 slices; acquisition time 56 sec
Images analysis






Advantage Window 4.0 GE station
Neuroradiologist +neurologist
ADC map
Diffusion hyperintensity
Stroke volume
ADC variation
Results

In 38 patients, both b1000 and b2000 diffusion were negative.

In 30 patients we diagnosed stroke
27/30 : the diffusion hyperintensity was of same
volume in b1000 and b2000
3/30 : discrepancy between b1000 and b2000
hyperintensity was found
Concordant b1000-b2000 diffusion : 27/30 stroke patients
same volume
better contrast ; lesser spatial resolution for b2000
ADC restriction in both
b 1000
b 2000
F, 43-yr-old, dysarthria, left facial palsy 2h
b1000
b2000
F, 61-yr-old, dizziness,
dysarthria, left hemiparesis
and facial palsy partially
regressive ; 3h
b1000
ADC map
b 2000
77%
81%
M,70-yr-old, left hemiparesis and regressive dysarthria; 3h
b1000
b2000
Discussion
Diffusion imaging is usually performed with a b1000 factor and
plays a major role in diagnosis of stroke.
In our study b1000 was concordant with b2000 diffusion in 98%
cases.
An additional b2000 diffusion allowed diagnosis in 2 cases where
b1000 was doubtful ; in 1 patient only b2000 diffusion showed
ischemia, while b1000 was normal.
Conclusion
A b2000 diffusion sequence is not necessary in every day
practice.
In case of high clinical suspicion of stroke and negative b1000
diffusion, an additional b2000 diffusion can be useful to establish
diagnosis of stroke.
.
Thank you for your attention!
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