Role of diffusion weighted magnetic resonance imaging of intra and extra axial intracranial lesions


  • V. Vishwas Chakra Department of of Radiology, Ananta Institute of Medical Sciences, Rajsamand, Rajasthan, India
  • Dalpat Singh Department of Radiology, Dr. S. N. Medical College, Jodhpur, Rajasthan, India
  • Mohan Makwana Department of Paediatrics, Dr S. N. Medical College, Jodhpur, Rajasthan, India
  • A. L. Chouhan Department of Radiology, Dr. S. N. Medical College, Jodhpur, Rajasthan, India
  • Kanwar Lal Department of Zoology, Jai Narayan Vyas University, Jodhpur, Rajasthan, India



ADC (Apparent diffusion coefficient), DWI, Intracranial lesions, MRI (Magnetic resonance imaging), T1W (T1 weighted), T2W (T2 weighted)


Background: Diffusion weighted imaging (DWI) has a wide range of applications in the evaluation of intracranial pathological conditions. It provides a specific diagnosis in few situations, and adds to the information provided by conventional sequence in many others.

Methods: The present study was conducted in the Department of Radiology, Dr. S. N. Medical College, Jodhpur, Rajasthan. Participants after understanding the study protocol and procedure, were asked to give their written consent for the study.

Results: In the study group of 115 patients (41%) were females and (59%) males. Infarcts comprised 45.2% of the total cases out of these acute infarcts constituted 30 cases (57.7%); 18 (34.6%) chronic infarcts and 4 (7.6%) were subacute infarcts. All cases of acute infarcts and 50% of subacute infarcts showed diffusion restriction. None of the chronic infarcts showed true restriction of diffusion. Among intra axial tumours true restriction was noted in 6 cases. 40% of glioblastoma multiforme showed true diffusion restriction. None of the low-grade gliomas or anaplastic astrocytomas showed diffusion restriction. 75% of medulloblastomas and 50% of lymphomas showed diffusion restriction. All cases of intracerebral abscesses showed true diffusion restriction. The cystic or necrotic component of none of the brain tumours included in this study showed diffusion restriction. All cases of arachnoid cysts seen in this study had low signal on DWI. 33% of meningiomas showed restricted diffusion in this study likely reflecting their high cellularity. All cases of HII showed true diffusion restriction. 25% of these cases showed no signal change on T2WI. Also, the extent of abnormality was noted to be more on DWI than on T2WI. Two cases of extradural empyema seen in this study showed restricted diffusion similar to abscesses. Hypertensive encephalopathy and demyelination did not show restricted diffusion reflecting absence of cytotoxic oedema in these conditions.

Conclusions: DW MRI helps in differentiating and characterizing intracranial lesions.


Lippincott Williams and Wilkins; Atlas SW, editors. Magnetic resonance imaging of the brain and spine. 4th ed. China; 2009:472-474.

Mascalchi M, Filippi M, Floris R, Fonda C, Gasparotti R, Villari N. Diffusion MR imaging: clinical applications. Radiol Med. 2005;109(3):155-97.

Chang SC, Lai PH, Chen WL, Weng HH, Ho JT, Wang JS et al. Diffusion weighted MRI features of brain abscess and cystic or necrotic tumours: comparison with conventional MRI. Clin Imag. 2002;26(4):227-36.

Karaarslan E, Arslan A. Diffusion weighted MRI in non-infarct lesions of the brain. Eu J Radiol. 2008;65:402-16.

Rima K, Rohit G, Anjali P, Veena C. Role of diffusion weighted MR imaging in early diagnosis of cerebral infarction. Ind J Radiol Image. 2003;3(2):213-7.

Gonzalez RG, Schaefer PW, Buonanno FS, Schwamm LH, Budzik RF, Rordorf G, et al. Diffusion-weighted MR imaging: diagnostic accuracy in patients imaged within 6 hours of stroke symptom onset. Radiol. 1999;210(1):155-62.

Schwartz R, Mulkern R, Gudbjartsson H, Jolesz F. Diffusion-weighted MR imaging in hypertensive encephalopathy: clues to pathogenesis. Am J Neuroradiol. 1998;19:859-62.

Van der Zwan A, Hillen B, Tulleken CA, Dujovny M, Dragovic L. Variability of the major cerebral arteries. J Neurosurg. 1992;77:927-40.

Schaefer PW, Grant PE, Gonzalez RG. Diffusion weighted MR imaging of the brain. Radiol. 2000;217:331-45.

Fu JH, Xue XD, Mao J, Chen LY, Wang XM. Early assessment of severe hypoxic-ischemic encephalopathy in neonates by diffusion-weighted magnetic resonance imaging techniques and its significance. Chin J Ped. 2007;45(11):843-7.

Cruz CH, Gasparetto EL, Domnigues RC. Diffusion weighted MRI in brain tumour. Neuroimaging Clin. 2011;21(1):27-49.

Tadeusz WS, Cristo C, Alex M, Wael MS, Katrijn VR, Robert L, et al. Diffusion weighted MR images of intracerebral masses: comparison with conventional MR. AJNR. 2001;22:969-76.

Christiansen P, Gideon P, Thomsen C, Stubgaard M, Henricksen O, Larsson H. Increased water self-diffusion in chronic plaques and in apparently normal white matter in patients with multiple sclerosis. Acta Neurol Scand. 1993;87:195-9.

Larsson H, Thomsen C, Frederiksen J, Stubgaard M, Henriksen O. In vivo magnetic resonance diffusion measurement in the brain of patients with multiple sclerosis. Magn Reson Imag. 1992;10:7-12.






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