Value of perfusion and diffusion MRI in hyper-acute stroke

Abstract EN

Aim : The aim of this study is to assess the value of functional magnetic resonance imaging in hyper-acute ischemic stroke and the best way of evaluation of any progressive process in post stroke period. Patients and Methods : 15 patients with hyperacute ischemic cerebrovascular stroke were enrolled in this study (10 males and 5 females), with their ages ranged from 23 years to 80 years with a mean age of 51.5 years.

Inclusion criteria were the clinical presentation with symptoms and signs suggestive of hyperacute ischemic cerebrovascular stroke.

The onset of symptoms was calculated from the last time the patient was normal (by their relatives). Results : Diffusion-weighted MRI provides a good estimate of the infarcted core in early cerebral ischemia.

Perfusion-weighted MRI gives insight into the hemodynamic alterations during cerebral ischemia.

The diffusion /perfusion mismatch (in cases when the perfusion defect is larger than the diffusion lesion) gives an estimate of the ischemic penumbra, which is salvageable by a proper intervention as thrombolysis.

During the 1st hours of stroke evaluation, regions with abnormal perfusion as assessed with PWI, are typically larger than DWI lesions and this occurs if the occlusion involving the distribution of large arterial supply, on the other hand, if the occlusion occurs in distribution of small perforators the regions with abnormal perfusion will be smaller than the DWI lesions. Conclusion : The diffusion /perfusion mismatch (in cases when the perfusion defect is larger than the diffusion lesion) gives an estimate of the ischemic penumbra, which is salvageable by a proper intervention as thrombolysis.