• Josep Puig, S Pedraza, G Blasco, J Daunis-I-Estadella, A Prats, F Prados, I Boada, M Castellanos, J Sánchez-González, S Remollo, G Laguillo, A M Quiles, E Gómez, and J Serena.
• Department of Radiology, Girona Biomedical Research Institute, Hospital Universitari de Girona Dr Josep Trueta, Girona, Spain. jpuigalcantara@yahoo.es
• AJNR Am J Neuroradiol. 2010 Aug 1;31(7):1324-30.

Background And PurposeThe quantification and clinical significance of WD in CSTs following supratentorial stroke are not well understood. We evaluated the anisotropy by using DTI and signal-intensity changes on conventional MR imaging in the CST to determine whether these findings are correlated with limb motor deficit in patients with MCA ischemic stroke.Materials And MethodsWe studied 60 patients within 12 hours of stroke onset. At admission, day 3, and day 30 of evolution, patients underwent multimodal MR imaging, including DTI sequences. We assessed the severity of limb weakness by using the motor subindex scores (5a, 5b, 6a, 6b) of the m-NIHSS and established 3 groups: I (m-NIHSS scores of 0), II (m-NIHSS, 1-4), and III (m-NIHSS, 5-8). FA values and rFAs were measured on the affected and the unaffected CSTs in the pons.ResultsFA values for the CST were significantly lower on the affected side compared with the unaffected side only at day 30 (P < .001), and the rFA was significantly correlated with the motor deficit at day 30 (P < .001; r = -0.793). The sensitivity, specificity, and positive and negative predictive values for motor deficit by rFA < 0.925 were 95.2%, 94.9%, 90.9%, and 97.4%, respectively.ConclusionsWD in the CST revealed by DTI correlates with motor deficit 30 days after MCA ischemic stroke. This study highlights the utility of imaging follow-up at 30 days and the potential of DTI as a surrogate marker in clinical trials.

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