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Stroke is a leading cause of death in Western countries, with a case mortality rate of 24% within the first month, higher than most forms of cancer. Echoplanar magnetic resonance imaging (EPI) enables rapid, non-invasive imaging and analysis of cerebral pathophysiology in acute stroke. Various functional imaging methods have been used in the evaluation of acute stroke. Positron emission tomography (PET) enables imaging and measurement of both perfusion and metabolism. At present, diffusion-weighted imaging (DWI) is the most used of the EPI parameters in clinical practice. DWI is both highly sensitive and specific for acute stroke. Magnetic resonance spectroscopy (MRS) allows the non-invasive assessment of metabolic changes during stroke. The addition of chemical shift imaging (CSI) to a multimodal acute stroke MRI examination may confer additional accuracy to the identification of at-risk ischemic tissue. EPI with DWI, PWI and MRS have now moved from the research arenainto routine clinical use.
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