Magnetic resonance diffusion-perfusion mismatch in acute ischemic stroke: An update

Figure 4 Main pattern of perfusion-diffusion mismatch: perfusion-weighted imaging < diffusion-weighted imaging, in a patient with acute stroke. Patient’s left-sided weakness was partially resolved 3 h after the onset of symptoms. A: Proton density (PD) weighted fast spin-echo image shows no abnormality; B: Diffusion-weighted imaging (DWI) shows a focal cortical ischemic abnormality; C: Relative cerebral blood volume (rCBV) map demonstrates a smaller lesion with decreased rCBV compared to the same abnormality as depicted in B; D, E: Follow-up PD images acquired 11 d later show a new tiny hyperintense infarct in the area of initially observed lesion on B and C. Note that the initial DWI lesion is larger than the final infarct volume. The patient’s symptoms resolved completely after 2 d (reprint from Sorensen et al Radiology 1996; 199: 391-401 with permission).