Diagnosis of acute ischaemic stroke with fluid-attenuated inversion recovery and diffusion-weighted sequences

We evaluated the feasibility and use of diffusion-weighted and fluid-attenu ated inversion-recovery pulse sequences performed as an emergency for patie nts with acute ischaemic stroke. A 5-min MRI session was designed as an eme rgency diagnostic procedure for patients admitted with suspected acute isch aemic stroke. We reviewed routine clinical implementation of the procedure, and its sensitivity and specificity for acute ischaemic stroke over the fi rst 8 months. We imaged 91 patients (80 min to 48 h following the onset of stroke). Clinical deficit had resolved in less than 3 h in 15 patients, and the remaining 76 were classified as stroke (59) or stroke-like (17) after hospital discharge. Sensitivity of MRI for acute ischaemic stroke was 98 %, specificity 100 %. MRI provided an immediate and accurate picture of the n umber, site, size and age of ischaemic lesions in stroke and simplified dia gnosis in stroke-like episodes. The feasibility and high diagnostic accurac y of emergency MRI in acute stroke strongly support its routine use in a st roke centre.