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Updated: Jul 11, 2026
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Published on: February 19, 2021
Restricted magnetic resonance diffusion-weighted imaging with mass lesions presenting as acute lesions
Michael J Schneck1, Kurian Thomas, Kenneth Goldberg
1Loyola University Medical Center, Maywood, Illinois, USA.
Abstract:
Diffusion-weighted imaging is useful for diagnosis of acute ischemic stroke. However, metastatic brain lesions may also demonstrate restricted diffusion on magnetic resonance imaging. We describe 4 cases (3 with metastatic neoplasms and 1 with a meningioma) with positive findings by diffusion-weighted imaging.
Insights
Diffusion-weighted imaging (DWI) aids acute ischemic stroke diagnosis. However, this technique may also detect restricted diffusion in metastatic brain lesions, mimicking stroke findings.
Area of Science:
- Radiology
- Neurology
- Oncology
Background:
- Diffusion-weighted imaging (DWI) is a key MRI technique for diagnosing acute ischemic stroke.
- Restricted diffusion on DWI can also be observed in various brain pathologies, including metastatic lesions.
- Differentiating stroke from metastatic disease using DWI alone can be challenging.
Purpose of the Study:
- To highlight that metastatic brain lesions can exhibit restricted diffusion on DWI.
- To present cases where metastatic neoplasms and meningioma mimicked ischemic stroke on DWI.
- To emphasize the importance of considering differential diagnoses in DWI findings.
Main Methods:
- Retrospective review of 4 cases with restricted diffusion on DWI.
- Analysis of imaging findings in patients with metastatic neoplasms and meningioma.
- Comparison of DWI findings with clinical and pathological data.
Main Results:
- All 4 cases demonstrated restricted diffusion on DWI.
- Three cases involved metastatic neoplasms, and one case was a meningioma.
- The DWI findings in these cases were suggestive of acute ischemic stroke.
Conclusions:
- Metastatic brain lesions, including neoplasms and meningioma, can present with restricted diffusion on DWI.
- DWI findings suggestive of stroke should prompt consideration of metastatic disease.
- Careful correlation with clinical context and other imaging sequences is crucial for accurate diagnosis.
