Magnetic resonance imaging of cerebral infarction: time course of Gd-DTPA enhancement and CT comparison

Thirty-five patients (7 females and 28 males) with cerebral infarction and suspicion of cerebral infarction of 4 h to 27 months duration were studied 45 times with magnetic resonance (MR) imaging using Gd-DTPA. Spin echo (SE) images were obtained before and after the administration of Gd-DTPA (0.1 or 0.15 mmol/kg) and compared with the enhanced CT. MR imaging using Gd-DTPA was more sensitive than enhanced CT and very useful for detecting a new focus of cerebral infarction, especially in the cases with multiple infarcted areas and for showing the extent of cortical and subcortical infarction. In most cases the MR enhancement was obvious in the subacute stage, especially after cerebral embolism, and the signal intensity of the lesion tended to show a gradual increase. The diagnosis of embolism was accepted on the basis of acute onset without prior TIA, coupled with angiography showing the embolus itself and/or a capillary blush and a wide area of infarction.