Diffusion weighted magnetic resonance imaging in the diagnosis and management of acute stroke

Objective: To evaluate the diagnostic accuracy of diffusion -weighted magnetic resonance (MR) imaging performed within 6 hours of the onset of stroke symptoms Study Design: Cross sectional study. Place and Duration of Study: This study was conducted at the Department of Radiology Nishtar Medical College & Hospital Multan from August, 2010 to August, 2011. Patients and Methods: Diffusion weighted MR imaging, along with conventional MR imaging performed in 36 patients who presented with acute stroke like symptoms within 6 hours of onset of symptoms. Diagnosis was noted. Patients admitted in medical ward. Follow up MR was performed after one weak. Findings compared with initial scan. Diffusion weighted MR and conventional MR diagnosis was compared with final clinical diagnosis. Sensitivities and specificities of diffusion weighted and conventional MR imaging (FLAIR, T2-w) noted comparing with final clinical diagnosis Results: Diffusion weighted MR imaging indicated stroke in 30 patients, all of whom had a final diagnosis of acute stroke Diffusion weighted images were negative in six patients, all of whom had a final clinical diagnosis other than stroke (100% sensitivity ,100% specificity).FLAIR images detected infarcts in 25 patients within 6hours of onset of symptoms out of 30 patients having stroke on final diagnosis( 83% sensitivity, 100% specificity). T2-w images detected infarcts in 22 patients on initial scan with sensitivity of 73% and specificity of 100%. Conclusion: Diffusion weighted MR imaging is highly accurate for diagnosing acute ischemic stroke within 6 hours of symptoms onset and is superior to conventional MR imaging.