Background: We postulated that diffusion kurtosis imaging (DKI) could classify heterogeneous stroke lesions on diffusion-weighted imaging (DWI) and improve our understanding of the characteristics of tissue injury. We aimed to retrospectively study different DKI parameters in patients with acute stroke reported in the literature.
Methods: We collected the DWI and DKI data of 41 patients (26 men, 15 women), including 86 cases of acute cerebral infarction in different brain regions. Of them, 20 patients had single infarction, whereas others had multiple infarctions. Acute cerebral infarction lesions were classified into two categories based on DKI and DWI parameters: type I, matched DKI and DWI parameters and type II, mismatched DKI and DWI parameters. Regions of interest (ROIs) were outlined within the most severely infarcted areas of each lesion according to each independent parametric map. In the control groups, same-sized ROIs were located in the corresponding region of the normal contralateral hemisphere. In both categories, DKI and DWI parameters followed a normal Gaussian distribution. We used the independent sample t-test to compare the differences in each group.
Results: In type I cases, fractional anisotropy, mean diffusivity, axial diffusivity, radial diffusivity, mean kurtosis (MK), and axial kurtosis (Ka) values were significantly different (P<0.05). In type II cases, only MK and Ka values were significantly different (P<0.05).
Conclusions: DKI can provide more information on acute ischemic brain infarction and enrich our understanding of ischemic tissue injury. This DKI and DWI parameters-based classification of acute stroke lesions may confer a renewed understanding of infarction cores.