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Pat Phillips

JAMA. 1999;281:2073-2074.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

Venice—Neuroimaging is beginning to come into its own for the precise diagnosis of stroke and, potentially, for determining and monitoring stroke therapy.

The integrated diffusion-perfusion MRI examination provides metabolic and hemodynamic information during the first critical hours after a stroke. A 24-second DWI protocol using high-speed echo-planar MRI sequences acquired 4 hours after onset of symptoms in a 64-year-old man (lying on his side) shows no clear lesion on the T2-weighted (nondiffusion-weighted) MRI scans. The corresponding diffusion-weighted and apparent diffusion coefficient (ADC) images clearly highlight the location and extent of the lesion. The hallmark of cerebral ischemia is the lower-than-normal ADC value, indicating slower-than-normal water proton diffusion within the acute lesion resulting from decreased metabolism and impaired cellular pumps. The 80-second perfusion-weighted (contrast bolus-tracking) protocol yields relative cerebral blood volume (rCBV), mean transit time (rMTT), and blood flow (rCBF) parametric maps that depict a large hemispheric increase . . . [Full Text of this Article]

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