Which statement about MRI versus CT in acute stroke is true?

Which statement about MRI versus CT in acute stroke is true?

• A. It is cheaper and more accessible than CT
• B. It is more expensive and less accessible than CT, but more sensitive to hemorrhage and early ischemia with DWI
• C. It cannot detect hemorrhage
• D. It is never used in acute stroke

Answer: (B)

In acute stroke imaging, you balance speed and availability with how well the modality detects brain injury. CT is fast, widely available, and the go-to to quickly rule out hemorrhage before deciding treatment. MRI, while more expensive and less accessible, provides greater sensitivity to acute ischemic changes thanks to diffusion-weighted imaging (DWI), which highlights restricted diffusion within minutes of stroke. It also uses sequences like gradient-echo or susceptibility-weighted imaging that can detect hemorrhage more sensitively than CT in some cases. Because of these factors, MRI is often chosen when there is time and need for detailed tissue characterization, despite its higher cost and longer exam time. This is why the statement describing MRI as more expensive and less accessible, yet more sensitive to hemorrhage and early ischemia with DWI, is the true one. The other options don’t fit because MRI is not cheaper or more accessible, it can detect hemorrhage, and it is used in acute stroke in appropriate settings.

In acute stroke imaging, you balance speed and availability with how well the modality detects brain injury. CT is fast, widely available, and the go-to to quickly rule out hemorrhage before deciding treatment. MRI, while more expensive and less accessible, provides greater sensitivity to acute ischemic changes thanks to diffusion-weighted imaging (DWI), which highlights restricted diffusion within minutes of stroke. It also uses sequences like gradient-echo or susceptibility-weighted imaging that can detect hemorrhage more sensitively than CT in some cases. Because of these factors, MRI is often chosen when there is time and need for detailed tissue characterization, despite its higher cost and longer exam time. This is why the statement describing MRI as more expensive and less accessible, yet more sensitive to hemorrhage and early ischemia with DWI, is the true one. The other options don’t fit because MRI is not cheaper or more accessible, it can detect hemorrhage, and it is used in acute stroke in appropriate settings.