Why was it done?
Patient presented with acute left-sided weakness. The working diagnosis was acute stroke.
How the study was performed:
A high-field 1.5 Tesla magnet was used to perform a routine brain MR exam, which includes a diffusion weighted sequence.
What the study showed:
The conventional T1 and T2 sequences demonstrated multiple foci of ischemic change but were indeterminate in differentiating a recent infarction from chronic infarction. The diffusion weighted sequence clearly identifies a recent subcortical infarction in the right hemispheric white matter that is the cause of the patient’s symptoms.
How did the exam impact patient management?
The exam allowed a definitive diagnosis of acute subcortical infarction caused by small-vessel disease as the cause of the patient’s symptoms. Embolic disease as the cause of infarction as well as other possible etiologies could be excluded preventing further costly work-up. The diagnosis could not have been made without the benefit of diffusion weighted MR, which can only be performed on high-field strength MR units.
