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MRI is more time consuming and less available than CT, but has significantly higher sensitivity and
specificity in the diagnosis of acute ischaemic infarction in the first few hours after onset.
diffusion restriction may be seen within minutes following the onset of ischaemia
for detailed discussion of DWI and ADC in stroke see diffusion weighted MRI in
acute stroke
less sensitive than DWI in the first few hours to parenchymal change
sulcal effacement and mass effect develop and become maximal in the first few days
10
fogging: between 1-4 weeks (peak 2-3 weeks) infiltration of inflammatory cells may
reduce T2 signal such that it becomes relatively isointense to normal parenchyma.
T1
low intensity roughly mirrors high T2 / FLAIR signal
T1 C+:
arterial enhancement (aka intravascular enhancement):
can be seen very early (0-2 hours) although it is more common at about
day 3
uncommon