The value of diffusion-weighted imaging for prediction of lasting deficit in acute stroke: an analysis of 134 patients with acute neurologic deficits

Acute stroke is one of the three major causes of death and disability in th e United States. Now that new, and possibly effective therapy is becoming a vailable, accurate, rapid diagnosis is important to provide timely treatmen t, while avoiding the risk of complications from unnecessary intervention. Our objective was to test the hypothesis that use of echo-planar (EPI) diff usion-weighted imaging (DWI) is more accurate than conventional T, weighted MRI in predicting progression to stroke in patients with acute ischemic ne urologic deficits. We studied 134 patients presenting with acute neurologic deficits to a community hospital emergency room with both conventional MRI and DWI within 72 h of the onset of the acute deficit. We found DWI signif icantly more sensitive to permanent neurologic deficit at discharge (sensit ivity 0.81) than conventional MRI (sensitivity 0.41). When available, DWI s hould be considered for routine use in patients being imaged for acute stro ke.