Fig. 1
From: SWI as a promising tool comparable to CT perfusion in evaluation of acute cerebral infarction
58-year-old male presented to stroke unit with left-sided weakness of 3-h duration, a DWI reveals normal signal intensity of both cerebral hemispheres. No definite areas of diffusion restriction. ASPECT score 10, CTP b revealed significant delay in mean transient time along the left frontotemporoparietal region (arrows) as well as the insula; however, deep nuclei are not affected compared to right side. The affected segments M1–6 and insula representing ASPECT score 3, c SWI reveals asymmetrical vessel sign with prominent dark dilated veins on the left cerebral hemisphere compared to right hemisphere along M1 to M6 segments; however, the deep nuclei and insula are not affected representing ASPECT score 4. The ASPECT score of SWI is very close to perfusion aspect score; on the other hand, the DWI reveals no abnormality. ASPECT score (3, 4 & 10), respectively. So there is DW/P mismatch denoting there is an area of risk to infarction (penumbra). Also there is DW/SWI mismatch similar to perfusion mismatch. This supports the role of SWI in detection of area at risk. D. SWI of the same patient revealed asymmetrical vessel sign in the form prominent cortical veins (arrow head) on the left cerebral hemisphere along (M1–M6 segments) representing the area at risk with aspect score 4