Imaging tutorial: differential diagnosis of bright lesions on diffusion-weighted MR images.

Stadnik TW, Demaerel P, Luypaert RR, Chaskis C, Van Rompaey KL, Michotte A, Osteaux MJ.
Department of Radiology, Academisch Ziekenhuis AZ Vrije Universiteit, Laarbeeklaan 101, 1090 Brussels, Belgium. cradrew@az.vub.ac.be

Radiographics. 2003 Jan-Feb;23(1):e7

High sensitivity (94%) and specificity (100%) have been reported in the diagnosis of acute cerebral infarction with diffusion-weighted magnetic resonance (MR) imaging. However, high signal intensity on diffusion-weighted MR images and low apparent diffusion coefficient values (similar to the findings in acute cerebral infarction) were reported in such diverse conditions as hemorrhage, abscess, lymphoma, and even Creutzfeldt-Jakob disease. The differential diagnosis of these conditions (eg, acute ischemic infarction and acute cerebral hemorrhage) is critical for the determination of appropriate treatment. The authors present a systematic review of bright lesions on diffusion-weighted MR images and their differential diagnosis, with emphasis on the practical and clinical approaches of differential diagnosis.

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