Detection of clinically silent infarcts after carotid endarterectomy by use of diffusion-weighted imaging.

Detection of clinically silent infarcts after carotid endarterectomy by use of diffusion-weighted imaging. Research Abstract Details 

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Detection of clinically silent infarcts after carotid endarterectomy by use of diffusion-weighted imaging. Abstract Text:

R J Feiwell,L Besmertis,R Sarkar,D A Saloner,J H Rapp,

BACKGROUND AND PURPOSE: Intraprocedural transcranial Doppler sonography has identified multiple microembolic events during and immediately after carotid endarterectomy (CEA) or angioplasty, yet the rate of clinically evident stroke is small. To determine the significance of the transcranial Doppler sonography findings, we examined patients by use of diffusion-weighted imaging and fluid-attenuated inversion recovery MR imaging before and immediately after CEA for evidence of clinically silent ischemic events. METHODS: Twenty-five patients with atherosclerotic disease of the carotid arteries underwent diffusion-weighted imaging and fluid-attenuated inversion recovery MR imaging performed, on average, 3 days before and 12 hours after CEA. Diffusion-weighted images were acquired in three orthogonal directions at b = 900. Pre- and postoperative neurologic examinations were performed by the same physician. RESULTS: After endarterectomy, 4.0% of the patients (one of 25 patients) showed a single, cortical focus of restricted diffusion and new fluid-attenuated inversion recovery hyperintensity, measuring <1 cm in diameter, ipsilateral to the CEA. The postoperative neurologic examination showed no change in status from the preoperative baseline state. This patient had an intraoperative course complicated by the development of a large luminal thrombus, necessitating thrombectomy. CONCLUSION: The use of diffusion-weighted imaging may serve to improve conspicuity of clinically silent infarcts after CEA. An important next step is to determine the risk factors that predispose to detectable parenchymal ischemic events.

Detection of clinically silent infarcts after carotid endarterectomy by use of diffusion-weighted imaging. Publishing Authors By Initials

RJ Feiwell,L Besmertis,R Sarkar,DA Saloner,JH Rapp,

For similar diagnosis: diagnostic techniques and procedures: diagnostic imaging: radiography: neuroradiography: echoencephalography: ultrasonography, doppler, transcranial research abstracts see: diagnosis: diagnostic techniques and procedures: diagnostic imaging: radiography: neuroradiography: echoencephalography: ultrasonography, doppler, transcranial research

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Detection of clinically silent infarcts after carotid endarterectomy by use of diffusion-weighted imaging. Journal Published:

PUBLICATION TYPE: Research Support, U.S. Gov't,

Journal: AJNR. American journal of neuroradiology

VOLUME: 22

Page Numbers: 646-9

Journal Abbreviation:

ISSN: 0195-6108

DAY: 14

MONTH: Apr

YEAR: 2001

Detection of clinically silent infarcts after carotid endarterectomy by use of diffusion-weighted imaging. Information

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LANGUAGE: eng

NlmUniqueID: 8003708

Detection of clinically silent infarcts after carotid endarterectomy by use of diffusion-weighted imaging. Keywords Mesh Terms:

KEYWORDS: Ultrasonography, Doppler, Transcranial

MESH TERMS: diagnosis

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Grant and Affiliation Information for Detection of clinically silent infarcts after carotid endarterectomy by use of diffusion-weighted imaging.

AFFILIATION: Department of Neurology, University of California, San Francisco 94143, USA.

Country: United States

AGENCY: United States NHLBI

GRANT: HL56307

ACRONYM: HL

MEDLINETA: AJNR Am J Neuroradiol

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