(ADC) A
diffusion coefficient to differentiate
T2 shine through effects or artifacts from
real ischemic lesions. In the human
brain, water
diffusion is a three-dimensional process that is not truly random because the diffusional motion of water is impeded by natural barriers. These barriers are cell membranes, myelin sheaths, white
matter fiber tracts, and protein molecules.
The apparent water
diffusion coefficients can be calculated by acquiring two or more images with a different
gradient duration and
amplitude (b-values). The
contrast in the
ADC map depends on the spatially distributed
diffusion coefficient of the acquired tissues and does not contain
T1 and
T2* values.
The increased sensitivity of diffusion-weighted
MRI in detecting acute ischemia is thought to be the result of the water shift intracellularly restricting motion of water
protons (cytotoxic edema), whereas the conventional
T2 weighted images show signal alteration mostly as a result of vasogenic edema.
The reduced ADC value also could be the result of decreased temperature in the nonperfused tissues, loss of
brain pulsations leading to a decrease in apparent
proton motion, increased tissue
osmolality associated with ischemia, or a combination of these factors.
The lower ADC measurements seen with early ischemia, have not been fully established, however, a lower apparent ADC is a sensitive indicator of early ischemic
brain at a stage when ischemic tissue remains potentially salvageable.
See also
Diffusion Weighted Imaging and
Diffusion Tensor Tractography.