Study on the Clinical Usefulness of Magnetic Resonance Imaging in Cases of Multiple Cerebral Infarctions

We investigated the clinical significance of MRI in cases of thrombotic multiple cerebral infarction. In nine patients with recent lacunar stroke, CT and MRI enhancement studies were performed on the same day. In MRI, injection of Gd-DTPA enhanced recent lesions in all patients except for one who was examined 4 weeks after ictus, and the effect was excellent. Recent infarcts could be identified only by Gd-MRI in four of nine patients. In patients with multiple small infarctions, the use of Gd-MRI makes it possible to distinguish recent infarcts from other lesions definitively. In order to clarify the significance of periventricular high intensity lesion (PVH) in T2-weighted (T2w) MRI, hemodynamic and neuropsychological examinations were carried out in 41 patients with multiple cerebral infarctions. All the patients had PVH, which was classified into three grades as follows; grade 1 (n=16) showing only a thin high intensity band along the body of lateral ventricles; grade 2 (n=15) showing a definite high intensity area around the lateral ventricles; grade 3 (n=10) demonstrating diffuse thick and irregular foci around the whole ventricles. In these patients, rCBF was measured by ^<133>Xe inhalation methods. Initial Slope Index (ISI) was calculated for estimating rCBF. Mini-mental State Test (MMT) was also performed for evaluating the grade of psychological abnormality. ISI in patients with grade 3 was significantly higher than ISI in those with grade 1 (p<0.05). The MMT score in patients with grade 1 was significantly higher than MMT in those with grade 2 and 3 (p