Which statement about MRI in acute stroke is accurate?

Which statement about MRI in acute stroke is accurate?

• A. It is cheaper and more accessible than CT
• B. It is less sensitive than CT for hemorrhage
• C. It is more expensive and less accessible than CT, but more sensitive for early ischemia with diffusion-weighted imaging
• D. It cannot detect ischemia

Answer: (C)

In acute stroke imaging, diffusion-weighted MRI is powerful because it can reveal ischemic tissue within minutes by showing restricted diffusion from cytotoxic edema. This makes MRI more sensitive than CT for detecting early ischemia when DWI sequences are used. However, MRI is generally more expensive and less accessible than CT, which is why CT remains the first-line modality in the hyperacute setting. CT is widely available, fast, and highly effective at ruling out intracranial hemorrhage, a critical step before certain treatments. So the statement that MRI is more expensive and less accessible than CT, but more sensitive for early ischemia with diffusion-weighted imaging, best captures how these imaging tools are used in acute stroke. The alternatives are less accurate because MRI can detect ischemia with DWI, and CT is the preferred method for rapid hemorrhage detection, while MRI’s cost and accessibility are typically greater.

In acute stroke imaging, diffusion-weighted MRI is powerful because it can reveal ischemic tissue within minutes by showing restricted diffusion from cytotoxic edema. This makes MRI more sensitive than CT for detecting early ischemia when DWI sequences are used. However, MRI is generally more expensive and less accessible than CT, which is why CT remains the first-line modality in the hyperacute setting. CT is widely available, fast, and highly effective at ruling out intracranial hemorrhage, a critical step before certain treatments. So the statement that MRI is more expensive and less accessible than CT, but more sensitive for early ischemia with diffusion-weighted imaging, best captures how these imaging tools are used in acute stroke. The alternatives are less accurate because MRI can detect ischemia with DWI, and CT is the preferred method for rapid hemorrhage detection, while MRI’s cost and accessibility are typically greater.