Diffusion and perfusion MRI, measurements of acute stroke events and outcome: present practice and future hope

The morphological, metabolic and functional changes of brain ischaemia can be studied using various MRI methods. These are readily available should the early visualisation of affected territories be needed. Morphological changes include the depiction of oedema on T1- and T2-weighted images, and metabolic changes are reflected on magnetic resonance spectroscopy. Functional changes reflect haemodynamic failure seen on diffusion- and perfusion-weighted imaging. Modelling of behaviour of T2 and diffusion changes could predict the histological outcome of affected tissue regarding cell recovery on necrosis. In addition, the combination of diffusion and perfusion MRI offers a potential prognostic value.