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| MR images of 49-year-old woman with abrupt left-side weakness 3 days before MR examination. With these conventional spin-echo sequences, one cannot distinguish recent from chronic ischemic insults. | |
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| Diffusion-weighted imaging study with color-encoded composite obtained with the modified Nakada method. Note that the early subacute infarction within the right corona radiata appears hyperintense with all sequences, reflecting restricted diffusion. The normal corona radiata appears blue on the color composite obtained with three ST gradients, reflecting predominantly superoinferior (S/I) fiber orientation. The infarction appears white as a result of isotropic restricted diffusion and superimposed T2 hyperintensity (“T2 shine-through”). A/P = anteroposterior, L/R = left to right. | |
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On the left, T1-weighted/FLAIR/T2-weighted RGB
composites. On the right, corresponding color
composites obtained with three ST gradients. An old lacunar infarct with hemosiderin (black
on both color composites) involves the right external
capsule and adjacent putamen. On more cephalad sections,
the early subacute infarct in the right corona
radiata and internal capsule (white on three-ST composites) can
be appreciated. Multiple chronic, presumably ischemia-mediated, deep and subcortical white matter foci are noted
at multiple levels (blue-green on T1-weighted/FLAIR/T2-weighted composites).
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