Abstract Background: Rapid differentiation of stroke subtypes is essential for appropriate acute management. While computed tomography remains widely available, magnetic resonance imaging (MRI) offers superior sensitivity for early ischaemia and high specificity for intracranial haemorrhage. Aim: This study aimed to evaluate the diagnostic performance of diffusion‑weighted imaging (DWI)/apparent diffusion coefficient (ADC) and T2* susceptibility sequences in differentiating stroke subtypes among adults presenting with suspected stroke. Materials and Methods: A prospective cross‑sectional study was conducted among 74 adults with suspected stroke who underwent multi‑sequence brain MRI. Sequences included T1‑weighted, T2‑weighted, fluid-attenuated inversion recovery (FLAIR), DWI/ADC and T2* gradient echo. Diagnostic parameters, including sensitivity, specificity and 95% confidence intervals (CIs), were calculated relative to a composite radiological reference standard. Results: Of 74 patients, ischaemic stroke accounted for 55 (74.3%) cases, haemorrhagic stroke for 17 (23.0%) cases and mixed lesions for 2 (2.7%) cases. DWI/ADC detected all ischaemic strokes (sensitivity 100%; 95% CI: 93.5–100). T2/FLAIR identified 52 of 55 ischaemic lesions (sensitivity 94.5%; 95% CI: 84.9–98.9). T2* detected all haemorrhagic and mixed lesions (sensitivity 100%; specificity 100%). Conclusion: Non-conventional MRI sequences significantly enhance stroke subtype differentiation. DWI/ADC demonstrated the highest sensitivity for ischaemic stroke detection, whereas T2* sequences were highly effective in identifying haemorrhage. Incorporation of these sequences into streamlined stroke MRI protocols may substantially improve diagnostic accuracy and clinical outcomes, particularly in resource-limited settings.
Isah et al. (Wed,) studied this question.