Benefits of MR PWI and DWI in the Diagnosis and Treatment of Hyperacute Cerebral Ischemia

As new treatments that may reverse cerebral ischemia have been developed, the role of neuroimaging has changed dramatically from simply anatomic depiction of early infarction to rapid and accurate evaluation of hyperacute ischemic stroke to accomplish urgent patient treatment and to estimate potential efficacy of recently developed treatments such as thrombolysis. The potential benefits of intervention have only begun to be realized and the success of intervention becoming increasingly dependent on timely imaging and accurate interpretation. We hypothesized that combined diffusion-weighted image (DWI) and perfusion-weighted image (PWI) added vital diagnostic value. (PWI) / (DWI) mismatch in hyperacute ischemic stroke provide important pathophysiological information about the penumbra which consists of hypoperfused, but not irreversibly damaged tissue surrounding the ischemic core. The purpose of this study was to investigate the value of DWI and PWI performed within the first 6 hours after stroke onset, which would help to define the role of MRI in the selection of patients who would obtain benefit from early therapeutic strategies and to study the influence of MR parameters on functional clinical outcome.