The clinical significance of cortical laminar necrosis on diffusion-weighted imaging at acute stage of cerebral infarction

Abstract

Objective To evaluate the clinical significance of cortical laminar necrosis(CLN) on diffusion-weighted imaging at acute stage of cerebral infarction. Methods 41 patients were retrospectively investigated who were diagnosed acute cerebral infarction in area of middle cerebral artery, and they got diffusion weighted imaging(DWI), magnetic resonance angiography(MRA) and colored ultrasonic inspection of cervical arteries within 48 hours after onset, with exclusion of cardioembolism, and 5 patients also had digital subtraction angiography(DSA). The patients were classified into CLN positive group or negative group. The stenosis or occlusion of ipsolateral MCA, intracranial and extracranial ICA were compared between the two groups. Results 9 patients' DWI had CLN, among whom 7 patients present moderate or more severe stenosis of feeding artery, and 5 patients who only had CLN signal presented severe stenosis or occlusion. 32 patients' DWI had not CLN, among whom 12 patients present moderate or more severe stenosis of feeding artery.The CLN positive group had a high incidence of ipsilateral intracranial ICA and(or) MCA moderate or severe stenosis or occlusion(55.6% vs 21.9%, χ2=3.85, P<0.05). The 5 patients who only had CLN signal had ipsilateral feeding artery severe stenosis.A positive correlation was found between CLN and moderate or severe stenosis or occlusion of ipsilateral intracranial ICA and(or) MCA(OR: 4.5, 95%CI: 1.0~20.2). Conclusion Patients with acute cerebral infarction and CLN on DWI were more likely to suffer from moderate or severe stenosis or occlusion of feeding large artery, and these patients should be evaluated vessel condition. Key words: Cerebral infarction; Cortical laminar necrosis; Diffusion-weighted imaging