الفهرس 
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Abstract
Susceptibility weighted imaging (SWI) allows direct visualization of the hypointense thromboembolism due to the high level of iron content in the thrombus and due to the increase in deoxyhemoglobin content causing marked T2* shortening in affected vessels downstream from the thrombus. The main purpose of this study was to highlight the role of addition of susceptibility weighted MR images to diffusion weighted images of the brain in diagnosis of patients with acute stroke. This prospective study was conducted on 30 patients who clinically suspected to have an acute cerebral ischemic or hemorrhagic stroke referred from the Neuropsychiatry department and outpatients clinics to Radio-diagnosis & Medical Imaging department , Tanta University Hospitals during the period from March 2019 to July 2021. Inclusion criteria:Patients with clinical manifestations of acute stroke.Exclusion criteria: patients with heart pacemaker, patients with metallic aneurysmal clip in the brain, patients with claustrophobia and vitally unstable patients. All the patients were subjected to the followings : Complete clinical examinations, laboratory investigations, conventional brain MRI, diffusion weighted imaging (DWI) with ADC map and susceptibility weighted imaging (SWI) . The age of the patients ranged from 36-88 years with mean value 63.47±12.221 years. Male cases were 18(60.0%) while female cases were 12(40.0%), 16(53.3%) were from rural and 14(46.7%) were from urban areas .17 (56.7%) patients had hypertension and 16(53.3%) patients had diabetes mellitus . Disturbed laboratory investigationds were also recorded . The most common presenting symptoms were headache in 26 patients followed by unilateral weakness in 14 patients and more than one symptom was detected in one patient . Ischemic stroke was detected in 80% of patients and hemorrhagic stroke was detected in the remaining 20% patients .Most of the lesions were detected in the subcortical sites in 14 patients and the left side of the brain was affected in 66.7% of the studied patients . The commonest occluded artery was middle cerebral artery in 23 (95.8%) patients. All of the studied patients showed hyperintense signals on T2WIs, FLAIR sequences and on diffusion weighted images (DWIs) and hypointense signals on the apparent diffusion coefficient map (ADC map) images. Prominent vessels sign (PVS) on SWI was found in 23 patients and 6 patients had macrohemorrhage (low signals ) on SWI . DWI and SWI showed a sensitivity of 100% and 96.7% respectively in detection of lesions of acute stroke in the studied patients and positive DWI-SWI mismatch was detected in 15 (65.2%) of the studied patients .