“A Study on the Daignostic Role of Diffusion Weighted MRI in Acute Ishemic Stroke’’

Authors

Saqib Rafiq Khan

B.Sc. Radiology and Imaging Technology, Mewar University Gangrar Chittorgarh Rajasthan India (India)

Mr. Bharat Bhushan Dagur

Assistant Professor at Mahatma Gandhi University of Medical Sciences and Technology (MGUMST), Jaipur, Rajasthan India. (India)

Article Information

DOI: 10.51244/IJRSI.2026.1304000156

Subject Category: Education

Volume/Issue: 13/4 | Page No: 1835-1842

Publication Timeline

Submitted: 2026-04-06

Accepted: 2026-04-11

Published: 2026-05-09

Abstract

Introduction: Acute ischemic stroke is a leading cause of morbidity and mortality worldwide. Early diagnosis is critical for timely intervention, especially within the narrow therapeutic window. Non-contrast CT has limited sensitivity in early detection. Diffusion-weighted MRI (DWI) offers superior early diagnostic capability.
Aims and objectives: To evaluate the diagnostic accuracy and clinical role of diffusion-weighted MRI in detecting acute ischemic stroke.
Materials and methods: A prospective observational study was conducted on 50–100 patients presenting with clinical features of acute ischemic stroke. MRI, including DWI and ADC mapping, was performed within 24 hours of symptom onset, findings were compared with non-contrast CT where available.
Results: DWI MRI detected acute infarcts in the majority of cases, including those with normal CT findings. Hyperintense signals on DWI with corresponding hypointensity on ADC maps confirmed restricted diffusion. The middle cerebral artery (MCA) territory was most commonly involved (42%). DWI showed significantly higher sensitivity (96%) compared to CT (28%).
Conclusion: DWI MRI is a highly sensitive and reliable imaging modality for early detection of acute ischemic stroke and should be routinely used when available.

Keywords

Diffusion-weighted imaging, Acute ischemic stroke, MRI, ADC, CT comparison.

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References

1. Nagaraja, N., Forder, J. R., Warach, S., & Merino, J. G. (2020). Reversible diffusion-weighted imaging lesions in acute ischemic stroke: A systematic review. Neurology, 94(13), 571–587. [Google Scholar] [Crossref]

2. Lakomkin, N., Pan, J., Stein, L., Malkani, B., Dhamoon, M., & Mocco, J. (2020). Diffusion MRI reversibility in ischemic stroke following thrombolysis: A meta-analysis. Journal of Neuroimaging, 30(4), 471–476. [Google Scholar] [Crossref]

3. Nawata, T. (2024). The role of diffusion-weighted imaging in acute stroke management. Imaging in Medicine, 16(5), 230–231. [Google Scholar] [Crossref]

4. Jiang, L., Sun, J., Wang, Y., et al. (2024). Diffusion- and perfusion-weighted imaging fusion to automatically identify stroke within 4.5 hours. European Radiology, 34(10), 6808–6819. [Google Scholar] [Crossref]

5. Alkhiri, A., Alturki, F., Alansari, N. M., et al. (2024). Prognosis and distribution of ischemic stroke with negative diffusion-weighted imaging: A systematic review and meta-analysis. Frontiers in Neurology, 15, 1376439. [Google Scholar] [Crossref]

6. Li, M., Lv, Y., Wang, M., Zhang, Y., Pan, Z., Luo, Y., et al. (2023). Perfusion-weighted imaging in predicting hemorrhagic transformation. Diagnostics, 13(22), 3404. [Google Scholar] [Crossref]

7. Brunser, A. M., Hoppe, A., Illanes, S., et al. (2022). Diffusion-weighted imaging as a predictor of stroke etiology. Frontiers in Neurology, 13, 9173225. [Google Scholar] [Crossref]

8. Nagaraja, N. (2021). Diffusion-weighted imaging in acute ischemic stroke. Journal of the Neurological Sciences, 425, 117435. [Google Scholar] [Crossref]

9. Rapillo, C. M., Dunet, V., Pistocchi, S., et al. (2024). MRI paradigm in acute stroke. Stroke, 55(5), 1329–1338. [Google Scholar] [Crossref]

10. Feigin, V. L., Abate, M. D., Abate, Y. H., et al. (2024). Global burden of stroke. The Lancet Neurology, 23(10), 973–1003. [Google Scholar] [Crossref]

11. Simonsen, C. Z., Madsen, M. H., Schmitz, M. L., et al. (2015). Sensitivity of DWI and PWI. Stroke, 46(1), 98–101. [Google Scholar] [Crossref]

12. Jones, J., Bhuta, S., Le, L., et al. (2025). Diffusion-weighted imaging in stroke. Radiopaedia. [Google Scholar] [Crossref]

13. Kidwell, C. S., Chalela, J. A., Saver, J. L., et al. (2004). Comparison of MRI and CT. JAMA, 292(15), 1823–1830. [Google Scholar] [Crossref]

14. Warach, S., Gaa, J., Siewert, B., Wielopolski, P., & Edelman, R. R. (1995). Acute stroke studied by DWI. Annals of Neurology, 37(2), 231–241. [Google Scholar] [Crossref]

15. Schellinger, P. D., Bryan, R. N., Caplan, L. R., et al. (1999). Evidence-based MRI in stroke. Lancet, 353(9155), 65–69. [Google Scholar] [Crossref]

16. González, R. G. (2012). Clinical MRI of acute ischemic stroke. Journal of Magnetic Resonance Imaging, 36(2), 259–271. [Google Scholar] [Crossref]

17. Lansberg, M. G., Thijs, V. N., Bammer, R., et al. (2000). Evolution of DWI lesion. Stroke, 31(5), 1099–1106. [Google Scholar] [Crossref]

18. Barber, P. A., Darby, D. G., Desmond, P. M., et al. (1998). Prediction of stroke outcome using DWI. Annals of Neurology, 43(6), 825–832. [Google Scholar] [Crossref]

19. Fiebach, J. B., Schellinger, P. D., Jansen, O., et al. (2002). CT vs MRI in hyperacute stroke. Stroke, 33(10), 2426–2432. [Google Scholar] [Crossref]

20. Rovira, A., Orellana, P., Alvarez-Sabín, J., et al. (2002). Hyperacute ischemic stroke imaging. AJNR, 23(1), 77–83. [Google Scholar] [Crossref]

21. Schlaug, G., Siewert, B., Benfield, A., et al. (1997). Time course of infarct evolution. Neurology, 49(1), 113–119. [Google Scholar] [Crossref]

22. Tong, D. C., Yenari, M. A., Albers, G. W., et al. (1998). Correlation of ADC changes. Neurology, 50(4), 864–870. [Google Scholar] [Crossref]

23. Baird, A. E., Benfield, A., Schlaug, G., et al. (1997). Enlargement of infarct. Stroke, 28(12), 2475–2480. [Google Scholar] [Crossref]

24. Sorensen, A. G., Buonanno, F. S., Gonzalez, R. G., et al. (1996). Hyperacute stroke evaluation. Radiology, 199(2), 391–401. [Google Scholar] [Crossref]

25. Heiss, W. D. (2011). Ischemic penumbra concept. Stroke, 42(11), 2941–2945. [Google Scholar] [Crossref]

26. Campbell, B. C. V., Christensen, S., Levi, C. R., et al. (2012). Perfusion imaging selection. New England Journal of Medicine, 367(10), 914–923. [Google Scholar] [Crossref]

27. Albers, G. W., Marks, M. P., Kemp, S., et al. (2018). Thrombectomy selection by imaging. New England Journal of Medicine, 378(8), 708–718. [Google Scholar] [Crossref]

28. Nogueira, R. G., Jadhav, A. P., Haussen, D. C., et al. (2018). DAWN trial imaging criteria. New England Journal of Medicine, 378(1), 11–21. [Google Scholar] [Crossref]

29. Powers, W. J., Rabinstein, A. A., Ackerson, T., et al. (2019). Guidelines for stroke management. Stroke, 50(12), e344–e418. [Google Scholar] [Crossref]

30. Wintermark, M., Albers, G. W., Alexandrov, A. V., et al. (2013). Acute stroke imaging recommendations. Stroke, 44(9), 2525–2535. [Google Scholar] [Crossref]

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