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Radiological diagnosis of acute stroke. Comparison of conventional MR imaging, echo-planar diffusion-weighted
B Geijer1, S Brockstedt, A Lindgren
1Department of Diagnostic Radiology, University Hospital, Lund, Sweden.
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.