Part 2
Diffusion weighted imaging
The DWI sequence is the most sensitive and specific for an acute / subacute infarct. This is what we see on the study:
Usually, when the DWI is this bright, it indicates true restricted diffusion. However, we want to be sure that it’s true restricted diffusion and not T2 shine through.
Which sequence should we look at to determine whether this is true restricted diffusion?
T1WI
T1WI can detect haemorrhage, which will make the DWI study less reliable, but it will not aid us in determining whether this is true restricted diffusion
ADC map
Yes, if the signal is low on the ADC we can confidently say that this is true restricted diffusion
FLAIR
If the signal is high on FLAIR it still doesn't differentiate between oedema from an infarct or T2-shine through on the DWI
T2WI
If the signal is high on T2WI it still doesn't differentiate between oedema from an infarct or T2-shine through on the DWI