Clinical applications of diffusion MR imaging for acute ischemic stroke.

Diffusion magnetic resonance imaging is the best imaging tool for detecting acute ischemic brain injury. Studies have shown its high accuracy for delineating irreversible tissue damage within the first few hours after stroke onset; however, the true value of any diagnostic tool is whether it can be used to guide clinical management. This review discusses the role of diffusion imaging in the evaluation of the patient with acute ischemic stroke, and how this role is influenced by other important stroke-related variables, including the level of vessel occlusion and the clinical deficit. The review focuses on decision-making for intravenous and intra-arterial reperfusion therapies.