Question 1790
{"accessible":false,"alternatives":[{"id":8891,"text":"ADC pseudonormalization"},{"id":8892,"text":"early DWI reversal"},{"id":8893,"text":"fogging phenomenon"},{"id":8894,"text":"T2 washout"},{"id":8895,"text":"T2 shine through"}],"archived":false,"correctAlternativeId":8891,"explanation":"\u003cp\u003e\u003cstrong\u003eADC pseudonormalization\u003c/strong\u003e\u0026nbsp;is a normal phase encountered in the subacute stage of\u0026nbsp;\u003ca href=\"https://radiopaedia.org/articles/ischaemic-stroke?lang=gb\"\u003eischemic stroke\u003c/a\u003e\u0026nbsp;and represents an apparent return to normal healthy brain values on ADC maps which does not, however, represent true resolution of ischemic damage.\u003c/p\u003e\u003cp\u003eIt is seen typically around 1 week following ischemic stroke and is thought to be due to a combination of cell wall breakdown and increase of extracellular edema (both of which result in facilitated diffusion - increased ADC values). At some point, these processes, combined with residual true abnormal restricted diffusion due to cellular swelling, result in ADC values ostensibly returning to those of a normal, healthy brain.\u0026nbsp;\u003c/p\u003e\u003cp\u003eAt this time, DWI images (e.g. b = 1000 s/mm\u003csup\u003e2\u003c/sup\u003e) will continue to show increased signal due to T2 shine-through.\u0026nbsp;\u003c/p\u003e","id":1790,"imageUrl":null,"imageAttribution":null,"imageAttributionCaseInfo":null,"firstQuestionPath":"/questions/1790","nextQuestionPath":"/articles/adc-pseudonormalisation/questions/1789","relatedArticles":[{"id":10716,"title":"T2 shine through","link":"/articles/t2-shine-through?lang=us"},{"id":28356,"title":"T2 washout","link":"/articles/t2-washout?lang=us"},{"id":41739,"title":"Early DWI reversal in ischemic stroke","link":"/articles/early-dwi-reversal-in-ischaemic-stroke?lang=us"},{"id":21647,"title":"Fogging phenomenon (cerebral infarct)","link":"/articles/fogging-phenomenon-cerebral-infarct?lang=us"}],"alsoUsedIn":[{"id":784,"kind":"Course","title":"Stroke Learning Pathway - page 784","link":"https://radiopaedia.org/courses/stroke-learning-pathway/pages/784"},{"id":1181,"kind":"Course","title":"Adult Neuroradiology Review Course - page 1181","link":"https://radiopaedia.org/courses/adult-neuroradiology-review-course/pages/1181"},{"id":1181,"kind":"Course","title":"Adult Neuroradiology Review Course - page 1181","link":"https://radiopaedia.org/courses/adult-brain-mri-review-course-2015-online-video/pages/1181"},{"id":2121,"kind":"Course","title":"Stroke Learning Pathway - peer review - page 2121","link":"https://radiopaedia.org/courses/stroke-learning-pathway-peer-review/pages/2121"}],"stem":"\u003cp\u003eADC values returning to normal\u0026nbsp;approximately 1 week after an ischemic infarct is known as...\u0026nbsp;\u003c/p\u003e","menuLinks":[{"text":"Report problem with question","url":"https://docs.google.com/forms/d/e/1FAIpQLSfO3soWYhOjJ7yErSysyCe5V4A1CqW7WK3rDA7MtAkecMGqNw/viewform?entry.1624461248\u0026entry.553583435=https://radiopaedia.org/questions/1790"}],"attemptsPercentages":[{"alternativeId":"8895","percentage":4},{"alternativeId":"8891","percentage":66},{"alternativeId":"8893","percentage":19},{"alternativeId":"8892","percentage":9},{"alternativeId":"8894","percentage":1}],"promptToLogin":false,"questionManager":false,"articleId":"adc-pseudonormalization"}