Additive Role of Susceptibility weighted image To Diffusion weighted image in the diagnosis Of Patients with Acute Stroke

Abstract

Background Acute ischemic stroke is defined as decrease in the brain blood supply caused by a blood vessel burst or being blocked by a thrombus, resulting in decreased oxygen and nutrients supply, causing brain tissue damage. Diffusion weighted sequences (DWI) gave us data on the pathophysiology of ischemia and may contribute to therapeutic decisions. Susceptibility weighted (SWI) sequences also have the potential to assess tissue viability. An ischemic area showed increased oxygen extraction fraction and slow flow contributed to greater level of deoxyhemoglobin and vein dilatation, which increases the prominence of vessels on SWI. This prominent vessel sign (PVS) on SWI has been reported due to increased oxygen extraction and matches well with venous and capillary deoxyhemoglobin levels. We aimed in this study to highlight the role of the addition of susceptibility weighted MR images to diffusion weighted images of the brain in the diagnosis of patients with acute stroke. Results: Prominent vessel sign (PVS) on SWI was found in 46 (76.7%) patients. Twelve (20%) patients had haemorrhage (low signals) on SWI and 2 (3.3%) patients had no SWI findings. DWI showed a sensitivity of (100%) and SWI showed a sensitivity of (96.7%) for the detection of infarct All of the 60 (100%) patients showed hyperintense signals on T2WIs, FLAIR sequences, and on DWI and hypointense signals on the ADC map. Conclusions: SWI is a potential adjunct in individuals with acute infarction, SWI may be helpful in identifying asymmetrical conspicuous hypointense arteries, positive DWI-SWI mismatch is an indicator of the ischemic penumbra and a prognostic indicator for infarct expansion.