Feasibility, Practicality and Logistics of a Multisequence Stroke MRI Protocol

The advent of new MRI techniques such as perfusion- (PWI) and diffusion- (DWI) weighted imaging in the early 1990s has added another dimension to diagnostic imaging in stroke [98, 195, 224, 236, 237, 372]. During the last few years a growing body of evidence has accumulated, documenting the usefulness of this method in the clinical setting of acute ischemic stroke. Several investigators found a significant correlation of DWI and PWI changes with follow-up imaging as well as with neurological outcome [18, 205, 322, 344, 371, 373]. Some authors concluded that different infarct patterns can be identified by means of DWI and PWI in hyperacute stroke, which may allow a more rational selection of therapeutic strategies based on the presence or absence of a tissue at risk. Nevertheless, substantial doubts remain regarding the feasibility and practicality as well as the validity of stroke MRI in the clinical setting [268, 397].