Fast diffusion kurtosis imaging for venous stroke caused by cerebral venous thrombosis

Abstract

Background: Diffusion kurtosis imaging (DKI) has been found to be more precise than diffusion weighted imaging (DWI) for detecting irreversible infarction in acute ischemic stroke. This study aimed to evaluate whether fast DKI has distinctive advantages in detecting venous stroke caused by cerebral venous thrombosis (CVT). Methods: All data from patients diagnosed with venous stroke due to CVT and qualified for mechanical recanalization treatment were collected. Fast DKI and DWI were obtained both before and after revascularization therapy, and lesions were measured. Lesion volumes on T2 weighted imaging (T2WI) were followed up at six months. Results: A total of 11 patients were recruited. Compared to the contralateral brain, ADC values of the lesions in pre-operation increased significantly (1340.12±235.42 vs 919.75±128.98, P < 0.05), while MK decreased (0.59±0.11 vs 0.81±0.12, P < 0.05). And the same changing trend about ADC values (1258.94±185.08 vs 949.81±148.52, P < 0.05) and MK values (0.64±0.12 vs 0.83±0.12, P < 0.05) in post-operation. There was no significant difference in the volume of lesions between DKI and DWI during the same examination period (26.97 vs 29.28, Ppre > 0.05; 13.34 vs 13.14, Ppost > 0.05). However, the lesion volume after revascularization was significantly reduced compared to the first DKI and DWI examinations (26.97 vs 13.34, P < 0.05), and the same as DWI (29.28 vs 13.14, P < 0.05). Volume of T2WI lesions after the 6th month diminished significantly compared with both DKI lesions and DWI lesions before treatment (7.25 vs 26.97, P < 0.05; 7.25 vs 31.19, P < 0.05). Fast DKI had a higher signal to noise ratio (SNR) than traditional DKI and DWI. Conclusion: The MK of the venous stroke lesions decreased significantly in the subacute stage of CVT, suggesting reversible infarction. Fast DKI has more distinctive superiority in the evaluation of venous stroke. Fast DKI approach may hold great promise for patients in clinical setting because of a higher SNR than DWI. But the sample need to be further expanded because of only 11 patients recruited.