Ready brain

For MRI, we used a 3T superconducting magnetic resonance system (Discovery MR750, General Electric Healthcare, Milwaukee, IL, USA) and a standard 8-channel head coil. The sequences and parameters were: transverse T₁WI-fluid-attenuated inversion recovery (FLAIR); transverse and sagittal T₂WI-periodically rotated overlapping parallel lines with enhanced reconstruction (PROPELLER); transverse DWI (echo-planar imaging sequence, b-value set as 0, 1000 s/mm²; TR = 3000 ms, TE = 97 ms, FOV, 240 × 240 mm; matrix = 160 × 160, slice thickness = 5.5 mm; intersection gap = 1.5 mm; number of excitations = 2), and ADC-Map. The automatic head scan software-READY Brain (General Electric) was used in the follow-up MR scanning process to avoid layer interleaving. The interval between the appearance of clinical symptoms and the first MRI examination was 1–11 days, with an average of 3.9 days. The interval between the first MRI examination and the first follow-up was 5–29 days, with an average of 10.3 days.

Two radiologists, each with more than 5 years of experience, confirmed the anatomical locations of the lesions and the abnormal signal intensities on T₁WI, T₂-WI, DWI, and ADC-map scans by cross-checking on an AW4.6 workstation (General Electric Healthcare). The ADC values were measured using Functool-ADC software (General Electric Healthcare). ROIs were automatically generated by the Functool-ADC software (round shape, 58 mm²), and the ROIs were carefully copied and placed in the center of the GCC and SCC (Fig. 1); this was jointly confirmed by two radiologists. To avoid layer interleaving during the follow-up examination, we used the automatic head-scan software READY Brain (General Electric Healthcare), in follow-up MR scans. Four groups of ADC values were measured and recorded: SCC in the initial examination (group 1), SCC in the first follow-up examination after treatment (group 2), GCC in the initial examination (group 3), and GCC in the first follow-up examination after treatment (group 4); each of the ROIs’ ADC values were measured by two radiologists, independently. If the data obtained from the same ROI by each radiologist differed, the average value was used for the statistical analysis.