Imaging tutorial: differential diagnosis of bright lesions on diffusion-weighted MR images

Radiographics. 2003 Jan-Feb;23(1):e7. doi: 10.1148/rg.e7.


High sensitivity (94%) and specificity (100%) have been reported in the diagnosis of acute cerebral infarction with diffusion-weighted magnetic resonance (MR) imaging. However, high signal intensity on diffusion-weighted MR images and low apparent diffusion coefficient values (similar to the findings in acute cerebral infarction) were reported in such diverse conditions as hemorrhage, abscess, lymphoma, and even Creutzfeldt-Jakob disease. The differential diagnosis of these conditions (eg, acute ischemic infarction and acute cerebral hemorrhage) is critical for the determination of appropriate treatment. The authors present a systematic review of bright lesions on diffusion-weighted MR images and their differential diagnosis, with emphasis on the practical and clinical approaches of differential diagnosis.

Publication types

  • Review
  • Systematic Review

MeSH terms

  • Acute Disease
  • Cerebral Hemorrhage / diagnosis*
  • Cerebral Hemorrhage / diagnostic imaging
  • Cerebral Infarction / diagnosis*
  • Cerebral Infarction / diagnostic imaging
  • Diagnosis, Differential
  • Diagnostic Imaging*
  • Diffusion Magnetic Resonance Imaging / methods*
  • Humans
  • Magnetic Resonance Angiography / methods
  • Radiography