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The sensitivity and specificity of MRI in stroke

From the Departments of Clinical Neurosciences and Nuclear Medicine, St. Joseph's Hospital Research Institute, University of Western Ontario, London, Ontario, Canada.

We compared MRI and CT in a study of 175 patients; 87 infarcts within a week, 40 from 1 to 40 weeks, 25 a year after onset, and 23 hemorrhages, 18 within 2 weeks and 5 in 4 to 8 weeks. Fifty-nine infarcts and eight hemorrhages had sequential scanning. MRI is more sensitive than CT in the early detection of cerebral infarcts. CT is the method of choice to rule out intracerebral bleeding, but MRI is more specific in later stages of hemorrhage. Periventricular hyperintensity is seen more frequently with diabetes than without. Hyperintense white matter patches are often unrelated to clinical events. MRI is useful in following the evolution of strokes and distinguishing acute and chronic infarcts without contrast agents.

Address correspondence and reprint requests to Dr. Kertesz, Department of Clinical Neurological Sciences, St. Joseph's Hospital, London, Canada, N6A 4V2.

Supported by the National Health Research and Development Program, Grant 6606-2240 to Dr. A. Kertesz and Dr. L. Nicholson. Dr. S.E. Black was the recipient of a Fellowship from the Ontario Heart and Stroke Foundation.

Received October 31, 1986. Accepted for publication in final form January 14, 1987.

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