Purpose: To examine the effect of varying the diffusion encoding strength (b value) on the contrast (signal difference, Delta S) between damaged and normal tissue during diffusion-weighted magnetic resonance imaging (DWI) assessment of acute ischemic stroke.
Materials And Methods: Phantoms with diffusion values approximating those expected in acutely infarcted and normal tissue were constructed from a mixture of agar and formaldehyde and imaged at varying b values (0-3000 mm(-2) second). Ten patients were imaged with multiple b values (500-2500 mm(-2) second) within 12 hours of stroke onset.
Results: Theoretical calculations showed that for any combination of diffusion coefficients there existed an optimal b value that was higher than the standard setting of 1000 mm(-2) second, and this was confirmed by the phantom studies. In the patients, increasing b from 1000 to 1500 mm(-2) second increased Delta S (average, 22.4%; P = 0.001), but no consistent benefit was seen at b = 2000 mm(-2) second (P = 0.408). This compared favorably with the average optimal b value of 1662 mm(- 2) second calculated from the patients.
Conclusion: These results suggest that increasing the b value from 1000 to 1500 mm(-2) second would increase contrast between infarcted and normal tissue in the setting of acute ischemic stroke.
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