Radiological diagnosis of acute stroke. Comparison of conventional MR imaging, echo-planar diffusion-weighted imaging, and spin-echo diffusion-weighted imaging.
OBJECTIVE
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.


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.


CONCLUSIONS
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.
Geijer
B
B
Department of Diagnostic Radiology, University Hospital, Lund, Sweden.
Brockstedt
S
S
Lindgren
A
A
Ståhlberg
F
F
Norrving
B
B
Holtås
S
S
D000208:Acute Disease; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001921:Brain / Q000473:pathology; D002561:Cerebrovascular Disorders / Q000175:diagnosis*; D017352:Echo-Planar Imaging; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged