Novel diffusion encoding modalities, such as tensor-valued encoding, can disentangle the effects of intra-voxel orientation dispersion and diffusion anisotropy, thereby resolving the fiber density from tissue heterogeneity. A rapid 2.5-minute protocol for tensor-valued diffusion MRI was applied for the first time to acute stroke. Microscopic anisotropy (µFA and MKA) and tissue heterogeneity (MKI) were higher in lesions of white and grey matter, in contrast to reduced DTI-derived fractional anisotropy at the voxel level. Elevated microscopic anisotropy in acute stroke may reflect increased trapped water in swollen axons, a measure independent of tract orientation dispersion.
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