Diagnostic Accuracy of Diffusion-Weighted MR Imaging Versus CT Brain in Hyperacute Stroke ??? A Prospective Study, Rohtas, Bihar

Author(s): Ankit Chaturvedi1, Dipu Singh2, Prashant Sinha3, Rishav Prasad4

The purpose of imaging is multifaceted, ranging from selecting the most
appropriate patients for treatment, to avoiding those who are unlikely to benefit.
In the present situation, imaging methods basically include cross-sectional imaging
by computed tomography (CT) or magnetic resonance imaging (MRI). The target
of the assessment is the vessels that supply the brain parenchyma and its
associated part at the same / distant perfusion level. In this study, we wanted to
evaluate the diagnostic accuracy of diffusion-weighted MR imaging with nonenhanced
CT in the diagnosis of hyperacute stroke.
This prospective study was conducted in Radiology Department at Narayan
Medical College Rohtas, Bihar. The study group includes a sample of 45 patients
who had come to the Department of Radiology within 6 hours of onset of stroke
symptoms. Non-enhanced computed tomography (NECT) and MRI were done in
all the patients and the results were studied. Study subjects were recruited as
following inclusion and exclusion criteria. Data was collected, entered and analysed
using Microsoft Excel, Epi Info and statistical package for social sciences (SPSS)
The hyperintense ischemic lesions on diffusion-weighted imaging (DWI) were
typically more visually distinct and easier to distinguish than the EIS on CT scans,
resulting in better overall values. When the five regions were looked at separately,
DWI had higher sensitivity than CT studies, which was close to the overall EIS
ranking. The basal ganglia and the insular ribbon had the greatest sensitivity in
both modalities. Eight of the 14 patients were classified in the consensus rating of
CT and DW imaging, resulting in a sensitivity of 57 percent for both methods, with
a bad value of 0.40 for CT and a good value of 0.68 for DW imaging.
DW imaging had a higher sensitivity and interrater agreement than CT imaging in
detecting early infarction.