Isolated DWI restriction in acute ischemia — useful window?

Diffusion restriction appears in minutes to hours and persists for days to weeks. ADC pseudonormalizes around 7–10 days — always correlate with FLAIR (DWI/FLAIR mismatch can estimate window).

Multiple sclerosis — current criteria?

McDonald 2017 criteria: dissemination in space (lesions in ≥ 2 of 4 typical regions) and time (enhancing + non-enhancing lesions simultaneously, or new lesion on follow-up MRI).

When to order perfusion / spectroscopy?

For brain tumor characterization (glioma grading), differentiation of recurrence vs radionecrosis and suspected metabolic disease.

Report template — MRI of skull/brain protocol stroke

When to use

Brain MRI is the most sensitive method for acute ischemia (DWI), demyelinating lesions (multiple sclerosis), epilepsy, dementia, tumors, CNS infections and vascular malformations. In emergencies, CT remains first-line due to speed; MRI completes the workup.

What to evaluate

Diffusion (DWI/ADC): acute restrictions and vascular distribution pattern.
FLAIR: white matter lesions, MS distribution pattern (McDonald criteria).
Post-gadolinium T1: focal enhancement, pattern (ring, solid, leptomeningeal).
Susceptibility-weighted (SWI/SWAN): microhemorrhages, deposits.
Deep structures, posterior fossa, sella, skull base.

Interactive template

Fill the blanks0/0

(PROTOCOLO AVC) Técnica: Exame realizado pelas técnicas ecoplanar pesada em difusão (DWI) e FLAIR. #### Foram também adquiridas imagens de perfusão através de sequência ecoplanar gradient-eco durante a injeção em bolus do contraste paramagnético #### e técnica SWAN. Análise: - Áreas de restrição à difusão: ausentes. #### - Áreas de isquemia aguda: área corticossubcortical / subcortical com restrição à difusão #### e hipersinal em FLAIR no ####. Determina efeito expansivo caracterizado por redução da amplitude dos sulcos corticais regionais. #### - Volume do infarto: estimado em mL. - Sistema ventricular: forma e dimensões conservadas. - Sulcos corticais e cisternas basais: amplitude preservada. - Parênquima encefálico: forma e características de sinal conservadas. Comparação: Estudos anteriores não disponíveis para a análise. Conclusão: #### Ausência de áreas sugestivas de isquemia aguda ao método. #### Área de isquemia aguda no ####. Volume do infarto estimado em #### mL.

Template in Brazilian Portuguese (clinical reporting language). Adapt to your service protocol. Not medical advice — the physician reviews, edits and signs.

How to use

Replace each [...] with the exam's measurement or descriptor.
Adapt the conclusion to your service protocol before signing.
Use the template as a starting point — not a replacement for physician review.
In Laudos.AI, dictate findings in natural speech and the AI structures text in this format for review.

Frequently asked

Isolated DWI restriction in acute ischemia — useful window?: Diffusion restriction appears in minutes to hours and persists for days to weeks. ADC pseudonormalizes around 7–10 days — always correlate with FLAIR (DWI/FLAIR mismatch can estimate window).
Multiple sclerosis — current criteria?: McDonald 2017 criteria: dissemination in space (lesions in ≥ 2 of 4 typical regions) and time (enhancing + non-enhancing lesions simultaneously, or new lesion on follow-up MRI).
When to order perfusion / spectroscopy?: For brain tumor characterization (glioma grading), differentiation of recurrence vs radionecrosis and suspected metabolic disease.

References

Thompson AJ et al., Lancet Neurol 2018 (McDonald 2017).
Powers WJ et al., Stroke 2019.