CAN DWI DISCRIMINATE BETWEEN AIS AND INTRACEREBRAL HEMORRHAGE (ICH)?
Although the experienced reader can discriminate ischemic from hemorrhagic stroke on DWI, the diagnosis of ICH by MRI is best done by gradient echo (GRE) pulse sequences. We did not specifically address intracerebral hemorrhage or hemorrhagic stroke in this assessment. However, there is good evidence in the literature supporting the equivalence of GRI and CT for acute ICH detection. With regard to DWI and ICH detection, one prospective multicenter study evaluated the ability of DWI to discriminate between ischemic and hemorrhagic strokes in 62 patients assessed within six hours with DWI, with a mean scan time of three hours. Baseline CT, follow-up imaging, and each patient’s clinical course were then used to validate the diagnosis of ischemic stroke or ICH. Three blinded raters independently rated all scans, and they were able to correctly identify all ischemic strokes and ICHs. Because the aim of that study was to evaluate whether MRI with DWI could differentiate ischemic stroke from
