Signal Change of Acute Cortical and Juxtacortical Microinfarction on Follow-Up MRI

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Fig 1.
A, Schematic drawing illustrating the classification of lesion location. Involvement of the gray matter alone (a), the GM and juxtacortical white matter (b), and the juxtacortical WM alone (c). B, Reference images for the classification of lesion location. Initial DWIs show acute cortical and juxtacortical microinfarcts (i–iii). Each lesion on follow-up SWI is classified as the involvement of the GM alone (a, iv, arrow), GM and juxtacortical WM (b, v, arrow), or juxtacortical WM alone (c, vi, arrow).
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Fig 2.
The imaging findings of an 82-year-old woman. The cortical infarct (arrows) shows hyperintensity on the initial DWI (A), hypointensity on the SWI (E), but it is not visible on the follow-up T2WI (B), FLAIR (C), and T2*WI (D).
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Fig 3.
The imaging findings of a 69-year-old man. The acute cortical and juxtacortical microinfarct (arrows) shows hyperintensity on the initial DWI (A). The follow-up T2WI (B) and FLAIR (C) images show juxtacortical white matter hyperintensity (arrows). The hypointensity on SWI (E) was seen only in the gray matter (arrows), but it is not visible on the follow-up T2*WI (D).

Table 1:

Sequence parameters for DWI, T1WI, T2*WI, FLAIR, and 3D multiecho spoiled GRE sequence^{^a}

	DWI	T2WI	FLAIR	T2*WI	3D Multiecho Spoiled GRE (SWI)
TR (ms)	6000	4000	12,000	800	58.4
Effective TE (ms)	60	85	140	17	No. of TEs^{^b}
Bandwidth (Hz per pixel)	1953	163	98	31	±62.5
Flip angle	90°	90°	90°	30°	15°
Section thickness (mm)	5	5	5	5	2
Matrix size	128 × 192	512 × 512	256 × 224	320 × 192	320 × 416
FOV (mm)	22 × 22	22 × 22	22 × 22	22 × 22	22 × 16.5
Acquisition time (min)	0.5	3.3	3.5	2.5	7
NEX	1	2	1	1	1
Parallel imaging method (reduction factor)	2	2	NA	NA	2

Note:—NA indicates not available.
↵a B-values of 0 and 1000 via single-shot multislice spin-echo echo-planar imaging for DWI.
↵b Number of echo times, 11; first echo time, 4.5 msec; uniform echo time spacing, 5 msec; repetition time, 58.4 msec.

Table 2:

Patient characteristics

Table 5:

Relationship between the lesion detection rate and the follow-up interval on SWI

	Follow-Up SWI Interval^{^a}
	Group A (0–12 mo)	Group B (12–36 mo)	Group C (36+ mo)
No. of lesions on initial DWI	70	54	56
No. of stroke events on initial DWI	13	9	13
Lesion-detection rate on SWI (No.) (%)	44 (63)	37 (69)	20 (36)