This case is a good reminder to include DWI/ADC sequences in the MRI study of acute onset brain disease. A 7-year-old Cavalier King Charles spaniel with a peracute onset of left forebrain signs less than 12 hours prior to imaging. There is a fairly well-defined intra-parenchymal lesion seen as a faint T2W and FLAIR hyperintensity confined to the gray matter of the left temporoparietal lobe with no associated mass effect. This lesion is T1W isointense, not associated with a signal void on SWI, and not contrast enhancing. This lesion is more conspicuous on DWI (top right image) and is restrictive on ADC (bottom right image).

 

These imaging findings are consistent with a non-hemorrhagic territorial infarct within the neurovascular territory of the left middle cerebral artery. DWI is used commonly in human patients to improve the sensitivity and specificity of the diagnosis of acute stroke, making it an ideal sequence for the positive identification of hyperacute stroke.

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For more information on the imaging of canine stroke, click on the link below.

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Courtesy of Dr Karina Graham at Veterinary Specialists of Sydney

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