TY - JOUR T1 - Diffusion tensor imaging may help the determination of time at onset in cerebral ischaemia JF - Journal of Neurology, Neurosurgery & Psychiatry JO - J Neurol Neurosurg Psychiatry SP - 986 LP - 990 DO - 10.1136/jnnp.2008.163584 VL - 80 IS - 9 AU - K Sakai AU - K Yamada AU - Y Nagakane AU - S Mori AU - M Nakagawa AU - T Nishimura Y1 - 2009/09/01 UR - http://jnnp.bmj.com/content/80/9/986.abstract N2 - Background and aim: The apparent diffusion coefficient (ADC) and anisotropy (eg, fractional anisotropy (FA)) of ischaemic tissue evolve over time. A reduction in diffusivity (ie, λ2 and λ3) is an important marker for characterising hyperacute-stage infarction, as these parameters may reflect axonal membrane status. The study examines whether transverse diffusivity could be useful in assessing white matter infarcts of various ages.Methods: Diffusion tensor imaging data from 44 adult patients (34 men, 10 women, aged 46 to 89 years, mean = 70.3) with acute white matter infarction (1–168 h) of the internal capsule were analysed. Relative eigenvalues were calculated as: (λipsi−λcontra)/λcontra. Lesions were classified based on theoretically expected evolution of diffusivity over time as follows: stage I, FA higher than the contralesional region of interest (ROI); stage II, diffusivity lower than the contralesional side for all eigenvalues; stage III, one of two transverse eigenvalues (λ2 or λ3) higher than the contralesional ROI.Results: Stage I infarcts (n = 5) were found primarily within 24 h of the onset of symptoms, with one case found on the third day. Stage II infarcts were found most commonly within 24 h (n = 18), and fewer after 24 h. After the first day, the ratio of stage III infarcts increased significantly. Thus, diffusivity-based classification of white matter infarcts seems to show a chronological trend.Conclusions: Diffusion anisotropy may be useful for defining the biological tissue clock of white matter infarctions. ER -