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Relationship between Lesion Types on MR Diffusion Weighted Imaging and Etiology of Acute Cerebral Ischemic Stroke

GE Ting-ting;XU Wen-an;CAO Shu-gang;GUO Qian;WANG Jian;Department of Neurology, the Affiliated Hefei Hospital of Anhui Medical University (the NO.2 People's Hospital of Hefei);  
Objective:To study the relationship between types of lesions on magnetic resonance diffusion weighted imaging(DWI) and etiology of acute cerebral ischemic stroke. Methods: A retrospective investigation was performed out in 461 patients with acute cerebral ischemic stroke. The participants were grouped according to DWI and modified TOAST(M-TOAST) classification. The relationship between the DWI and M-TOAST classificatin was analyzed. Results: The imaging appearance on DWI was related with M-TOAST classification(rs=-1.87, P=0.000). Among all the patients, 21 patients with large penetrating branch infarction(x2=6.189, P=0. 013), 6 patients with small penetrating branch infarction(x2=102.869, P=0.000), 33 patients with single infarction of inferior tentorium of cerebellum(x2=4.420, P=0.036), 21 patients with scattered infarctions involving one artery territory of anterior circulation(x2=11.376, P=0.001), 13 patients with scattered infarctions involving one artery territory of posterior circulation(x2=7.937, P=0.005), 29 patients with unilateral multiple infarctions of anterior circulation(x2=10.725, P=0.001) and 21 patients with multiple infarctions of posterior circulation(x2=67.984, P=0. 005) were closely associated with atherothrombosis. 11 patients with single cortical-subcortical infarction(x2=27.285, P=0.000), 6 patients with bilateral multiple infarctions of anterior circulation(x2=5.292, P=0.021), 9 patients with multiple infarctions of posterior circulation(x2=4.478, P=0.034), 5 patients with bilateral multiple infarctions of anterior and posterior circulation(x2=7.979, P=0.005) were associated with cardioembolism. One hundred and twenty patients with small penetrating branch infarction(x2=268.027, P=0.000) were associated with small artery disease. Conclusion: DWI is useful in predicting the etiology of acute cerebral ischemic strokes.
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