Diffusion-weighted magnetic resonance imaging for acute ischemic stroke diagnosis

• Incidence of Diffusion-Weighted Imaging Lesions in Patients With Intracerebral Hemorrhage in the Acute and Subacute Time Periods
• Comparison of lesion segmentation performance in diffusion-weighted imaging and apparent diffusion coefficient images of stroke by artificial neural networks
• Cerebral hypoperfusion-related hemichorea: A case report and literature review
• Brain under pressure: Insights into diving-related lesions: a descriptive study
• Intracranial Cryptococcoma Mimicking Stroke or Brain Tumor: A Diagnostic Challenge in an Immunocompetent Patient
• Genetic and imaging features of CADASIL patients with acute ischemic stroke
• Multi-classification Deep Learning Approach for Diagnosing Stroke Type and Severity Using Multimodal Magnetic Resonance Images
• Associations between multiple acute infarctions and intracranial arterial stenosis with functional outcomes in anterior circulation acute ischaemic stroke reperfusion therapy: results from the China National Stroke Registry III

Diffusion-weighted magnetic resonance imaging is a better imaging method than conventional MRI in detecting early ischemic lesions in stroke patients. Lesion size as measured on DWI scans and, to a lesser extent, ADC values are potential parameters for predicting clinical outcomes in acute stroke patients ¹⁾.

A small but significant percentage of patients with AIS have a negative DWI scan. Patients with neurologic deficits consistent with posterior circulation ischemia have 5 times the odds of having a negative DWI scan compared to patients with anterior circulation ischemia. AIS remains a clinical diagnosis and urgent reperfusion therapy should be considered even when an initial DWI scan is negative ²⁾.

In patients with large hypertensive intracerebral Hemorrhage, white matter disease, intraventricular hemorrhage volume and large reductions in SBP over the first 24 h were independently associated with DWI lesions. Further investigation of potential hemodynamic mechanisms of ischemic injury after large intracerebral Hemorrhage is warranted ³⁾

Diffusion-weighted magnetic resonance imaging (DWI) is widely appreciated as an indispensable tool in the examination of the central nervous system. It is considered useful not only for the detection of acute ischemic stroke but also for the characterization and differentiation of brain tumors and abscess.

A network meta-analysis provides supporting evidence to the idea that DWI has a higher diagnostic value regarding ischemic stroke among MRI methods, and CT perfusion has a poor diagnostic value among CT methods, which provide therapeutic considerations for Ischemic stroke intervention ⁴⁾.

Sartoretti et al. assessed the value of computed and acquired high b-value DWI in comparison with conventional b = 1000 s mm-2 DWI for ischemic stroke at 3T.

Synthetic images at b = 1000 and 1500 s mm-2 and acquired DWI images at b = 2000 s mm-2 may be of clinical value due to improved lesion conspicuity ⁵⁾.