Diffusion Tensor Imaging of Chronic Right Cerebral Hemisphere Infarctions

OBJECTIVE We describe the essential diffusion tensor imaging (DTI) findings of right cerebral hemisphere infarctions and study whether the DTI parameters and neurological status differ in patients with visible wallerian degeneration (WD) or small hemorrhagic transformation (HT) in the chronic stage. METHODS Twenty-five stroke patients underwent DTI. Fractional anisotropy (FA) and mean diffusivity (MD) were measured in the infarction area, its corresponding contralateral area and both hemispheres in the centrum semiovale, cerebral peduncle, thalamus, internal capsule, and in corpus callosum genu, truncus, and splenium. The neurological scores were assessed in the acute and chronic phase. The subgroup analysis of WD and HT was conducted. RESULTS MD was higher in the right hemisphere (all P-values < .05), except on the internal capsule. FA was decreased in the infarction site, right cerebral peduncle, and centrum semiovale compared to the left side (P < .05). The chronic Rankin Scale was worse in the WD group. Their DTI parameters were different in 3 locations compared to patients with no WD. The HT group received fewer points in the chronic Barthel Index, and they had lower FA in the thalami. CONCLUSIONS DTI reveals the changes after infarction in the lesion site and elsewhere. The patients with visible WD or HT have more changes in the DTI parameters and worse outcome scores.