Background and Purpose: Diffusion-weighted MRI (DWI) is highly sensitive in detecting early cerebral ischemic changes in acute stroke patients. In this study we compared the sensitivity of DWI with that of conventional MRI techniques.

Materials and Methods: We performed DWI, ADC, fluid-attenuated inversion recovery, spin-echo T2 and T1 weighted MRI sequences in 100 patients with suspected stroke. Imaging features of DWI, ADC were correlated with the routine MRI sequences.

Results: The study comprised 61% males and 39% females. Infarcts constituted 100.0% of cases of the total cases in this study. Of this, 72.0% were acute infarcts, 22.0% were chronic infarcts and 6.0% were sub-acute infarcts. All cases of acute infarcts and 33% of sub-acute infarcts showed diffusion restriction. None of the chronic infarcts showed true restriction of diffusion. No signal abnormality was noted in 13.8% of acute infarcts on T2W images.

Conclusions: Diffusion weighted MRI has been proven to be of excellent use in the characterization of infarcts and in the detection of acute infarcts. It is especially useful in the initial few hours of the ischemic insult when conventional MR sequences may be inconclusive and may not detect the infarct. In the setting of multiple infarcts it helps detect the acute ones and is helpful in differentiating acute, sub-acute and chronic infarcts. Thus diffusion weighted MR imaging has to be included in any standard imaging protocol for stroke patients.

Key Words: cerebral infarction, magnetic resonance imaging, DWI, ADC, acute stroke, chronic stroke, gliosis.