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A comparison of the ADC and T 2 mapping in an assessment of blood‐clot lysability
Author(s) -
Vidmar Jernej,
Blinc Aleš,
Serša Igor
Publication year - 2010
Publication title -
nmr in biomedicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.278
H-Index - 114
eISSN - 1099-1492
pISSN - 0952-3480
DOI - 10.1002/nbm.1422
Subject(s) - thrombolysis , effective diffusion coefficient , tissue plasminogen activator , medicine , fibrinolysis , nuclear medicine , diffusion mri , t plasminogen activator , magnetic resonance imaging , radiology , myocardial infarction
The structural characteristics of blood clots are associated with their susceptibility to thrombolysis. As their morphology can be characterized by MRI, several attempts have been made to link the lysability of blood clots with their MRI properties; however, so far no study has associated a clot's lysability with the diffusion properties of the water in the clot. The apparent diffusion coefficient (ADC) is highly sensitive to changes in serum mobility and may be used to distinguish between the non‐retracted and the fully retracted regions of the blood clot. Therefore, the ADC may be a suitable, or even a better, marker for an assessment of the clot's retraction and consequently for its lysability than the relaxation time T 2 . The purpose of this study was to evaluate whether it is possible to predict the outcome of clot thrombolysis by ADC mapping prior to treatment. After two hours of thrombolysis using a recombinant tissue plasminogen activator in plasma, whole‐blood clots were efficiently dissolved in regions with ADC ≥ 0.8 × 10 −9 m 2 /s or T 2 ≥ 130 ms, whereas dissolution was poor and prolonged in regions with ADC < 0.8 × 10 −9 m 2 /s or T 2 < 130 ms. An analysis based on a comparison between the initial and final ADC and T 2 maps after two hours of thrombolysis showed that the ADC can more accurately detect the different grades of clot retraction than T 2 and predict the regions of a clot that are resistant to thrombolysis. Therefore, the ADC could be used as an efficient prognostic marker for the outcome of thrombolysis. However, in vivo studies are needed to test this idea. Copyright © 2009 John Wiley & Sons, Ltd.