T2 shinethrough artifact in DWI

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Brain MR imaging 2 hours after onset of symptoms

Persistent diffusion abnormalities in the brain stem of patient 2.

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Axial fluid-attenuated inversion recovery MR of same patient as in Fig 1 done 19 days later (patient remained hospitalized) now showing an isointense area.

Isolated restricted diffusion in a patient who recovered without residual symptoms.A, DW image shows asymmetric (right greater than left) high signal intensity.

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Marked progression of PML documented by serial MR studies

Presentation transcript:

T2 shinethrough artifact in DWI T2 shinethrough artifact in DWI. A, T2-weighted fluid-attenuated inversion recovery image shows numerous nonspecific periventricular and subcortical hyperintense foci, as well as a larger wedge-shaped region of hyperintensity in the right parietal lobe sugg... T2 shinethrough artifact in DWI. A, T2-weighted fluid-attenuated inversion recovery image shows numerous nonspecific periventricular and subcortical hyperintense foci, as well as a larger wedge-shaped region of hyperintensity in the right parietal lobe suggestive of infarct. B, Combined DWI image at the same axial level reveals that the right parietal abnormality is hyperintense, suggesting acute ischemia. C, Corresponding ADC map demonstrates elevated mean diffusivity within the abnormal region, consistent with chronic infarction. D, Low signal intensity within the lesion on the attenuation coefficient image confirms that the DWI signal-intensity hyperintensity is due to T2 shinethrough and does not reflect reduced diffusion as would be seen in an acute infarct. P. Mukherjee et al. AJNR Am J Neuroradiol 2008;29:632-641 ©2008 by American Society of Neuroradiology