Hyperacute stroke: Evaluation with combined multisection diffusion-weighted and hemodynamically weighted echo-planar MR imaging

PURPOSE: To evaluate acute stroke with conventional, multisection diffusion-weighted (DW), and hemodynamically weighted (HW) magnetic resonance (MR) imaging. MATERIALS AND METHODS: The three MR imaging techniques were performed in 11 patients within 10 hours of the onset of acute hemiparesis. The volume of DW and HW abnormalities were compared with infarct volumes depicted at initial and/or follow-up MR or computed tomography (CT). RESULTS: Findings at DW and HW imaging were abnormal in nine of the 11 patients, despite normal findings at initial CT and/or MR. In all nine patients, infarcts were depicted at follow-up CT or MR. The DW abnormality was generally smaller and the HW abnormality was generally larger than the infarct volume determined at subsequent imaging. In the two patients with normal findings at DW and HW imaging, symptoms resolved completely within 1-48 hours. CONCLUSION: Different aspects of hyperacute cerebral ischemia are depicted at DW and HW imaging before infarction is depicted at conventional MR or CT. These techniques may improve stroke diagnosis and may contribute to advances in treatment.