MRI ROLE OF DIFFUSION WEIGHTED

IMAGING

• Name :- Kajal Choudhary

• PRN :- 18040121089

• B.S.C Medical Technology

 DIFFUSION WEIGHTED IMAGING

• Diffusion-weighted imaging (DWI) is a form of MR imaging based upon

measuring the random Brownian motion of water molecules within a voxel of
tissue.
• In normal tissue, extracellular water diffuses randomly whereas in ischaemic
tissue, cells swell and absorb water thereby reducing average diffusion.
• DWI is a method to evaluate the molecular function and micro-architecture of the
human body.
• DWI signal contrast can be quantified by apparent diffusion coefficient maps and
it acts as a tool for treatment response evaluation and assessment of disease
progression.
• DWI is more sensitive to physiologic state of brain tissue, acute neurologic
deficit, infarct, stroke, inflammation, infection, tumor & trauma.
Principle of Diffusion weighted imaging
 ‘b’ value
• The sensitivity of diffusion is controlled by gradient
factor ‘b’’
• ‘b’ value determines the diffusion attenuation by
modification of the duration and amplitude of the
diffusion gradient.
• It can be expressed in units of s/mm²
• Typical ‘b’values range from 500 s/mm² to1000 s/mm².
• The higher the b values, the better the sensitivity of
diffusion weighted imaging (usually three to four b
values are used in diffussion-weighted sequences b50,
b500, b1000 and b1400).
APPARENT DIFFUSION COEFFICIENT
(ADC)

• Area with restricted diffusion = decreaed

ADC, appear dark (hypointense) on DWI
image.

• Area with unrestricted diffusion =

Increased ADC, appear bright
(hyperintense) on DWI image.

• Area of T2 shine through appear

normal/bright but not dark
 ARE ALL THE BRIGHT LESIONS IN DWI DUE TO
RESTRICTED DIFFUSIONE ALONE ?

•The answer is “NO”.

•T2 shine through is a condition where T2 high signal shows up in DWI image.
 HOW TO FIND WHETHER THE BRIGHT SIGNAL IS
DUE TO RESTRICTED DIFFUSION?

• Go for (Apparent diffusion coefficient) ADC mapping.

• If it is a true restricted diffusion, it will appear dark in ADC map whereas when ran
over T2 shine through, it will appear normal/bright in ADC but never dark.

• As it is not through diffusion, but is an artifact since DWI is a type of T2W imaging.
 T2W DWI ADC

DARK

DIFFUSION
RESTRICTION

INCREASED
DIFFUSION

T2 SHINE
THROUGH
Bright
• DIFFUSION TENSOR IMAGING
 TECHNICAL PARAMETER

• T2 Axial :-
• 1. Plan the axial slices on the sagittal plane; angle the position block parallel to the line
joining glabella to foramen magnum.
TR TE SLICE FLIP PHASE FOV MATRIX GAP b value NEX
• Parameter -
0.50
7000-9000 110 5mm 130 R-L 192x192 210-230 10% 4
0.1000

• 2. Plan the axial slices on the coronal plane; angle the position block perpendicular to the
brain stem or line of third ventricle.
TR TE SLICE FLIP PHASE FOW MATRIX GAP b value NEX
• Parameter -
3000 85 4mm - R-L 128x128 210 10% 0.1000 4
 DIFFUSION WEIGHTED MRI IN ACUTE STROKE

• DWI is commonly used in acute ischemic stroke .

•  Conventional MRI sequences (T1WI, T2WI) may

not demonstrate an infarct for 6 hours, and small
infarcts may be hard to appreciate on CT for days,
especially without the benefit of prior imaging. 

• Increased DWI signal in ischemic brain tissue is

observed within a few minutes after arterial
occlusion.

• Acute stroke demonstrated by diffusion Mri

represent regions with slower diffusions due to
intracellular water accumulation and/or shrinkage
of the extracellular spaces.
 RADIOGRAPHIC APPEARANCE
• The appearance of DWI/ADC depends on the timing. 

• ADC value decreases with maximal signal reduction at 1 to 4 days.

ACUTE
(0-7 DAYS) • marked hyperintensity on DWI (a combination of T2 and diffusion weighting), less
hyperintensity on exponential images, and hypointensity on ADC images.

• ADC pseudonormalization occurs in the second week (7-15 days).

• ADC values rise and return to near baseline.
SUBACUTE • irreversible tissue necrosis is present despite normal ADC values.
(1-3 WEEKS) • DWI remains hyperintense due to T2 shine through.
• after 2 weeks ADC values continue to rise above normal parenchyma and the region
appears hyperintense .

CHRONIC • ADC signal high

( >3 WEEKS) • DWI low signal (as T2 hyperintensity and thus T2 shine through resolve).
 DWI OF BRAIN ABSCESSES VS NECROTIC TUMOR

• DWI is useful in providing a greater degree of

confidence in distinguishing brain abscesses from
cystic or necrotic brain tumors than conventional
MRI and seems to be a valuable diagnostic tool.
• The abscesses have a high signal on DWI and a
reduced apparent diffusion coefficient (ADC)
within the cavity.
• This restricted diffusion is thought to be related to
the characteristic of the pus in the cavity; which
may in turn lead to reduced water mobility, lower
ADC and bright signal on DWI.
THANKYOU