Radiological Diagnosis of Acute Stroke

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Abstract
Purpose: To compare conventional MR imaging, echo-planar diffusion-weighted imaging (EP-DWI) and spin-echo diffusion-weighted imaging (SE)-DWI at radiological diagnosis of acute stroke. Material and Methods: Twenty-seven patients (30–85 years old) were examined. Clinical examination was performed before MR imaging. All MR examinations were assessed by an experienced neuroradiologist blinded to clinical findings. Results: In EP-DWI, every patient had a lesion corresponding to the clinical findings. EP-DWI was used as the gold standard. In conventional PD + T2 imaging, 23/59 focal lesions were interpreted as acute, which was false in 11 lesions, and 36/59 lesions were considered to be old, 6 were in fact acute. Nine acute lesions were only detected retrospectively and 12 acute lesions were not detected at all on PD + T2. SE-DWI including the apparent diffusion coefficient correlated fairly well with EP-DWI but the procedure was impractical. Conclusion: EP-DWI is reliable for diagnosis of early ischemic stroke, while SE-DWI performs reasonably well. Conventional PD + T2 imaging is not reliable for diagnosis of early ischemia.

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