Diffusion and perfusion MR imaging in acute ischemic stroke: a comparison to SPECT

Diffusion (DWI) and perfusion (PWI) magnetic resonance imaging are relative ly new methods of clinical imaging that probably can detect infarcted (DWI) and hypoperfused but still salvageable tissue (PWI) in acute human stroke. Forty-six acute stroke patients were imaged within 24 h of ictus, on the s econd day and after a week. SPECT was also performed on 23 patients in the acute phase (first or second day). On the first day, mean volume of hypoper fused tissue was significantly greater (P < 0.001) than the infarcted tissu e. The initial hypoperfusion volume correlated significantly with the final infarct size (P < 0.001). The initial perfusion-diffusion mismatch correla ted significantly with the infarct growth (P less than or equal to 0.001). The hypoperfusion volumes measured from PWI and SPECT correlated significan tly (P < 0.001). In conclusion, combined DWI and PWI is a powerful tool in evaluating the hemodynamics of acute ischemic stroke and can predict the in farct growth during 1 week. (C) 2001 Elsevier Science Ireland Ltd. All righ ts reserved.