(DTI) Diffusion tensor imaging is the more sophisticated form of DWI, which allows for the determination of directionality as well as the magnitude of water diffusion. This kind of MR imaging can estimates damage to nerve fibers that connect the area of the brain affected by the stroke to brain regions that are distant from it, and can be used to determine the effectiveness of stroke prevention medications.
DTI (FiberTrak) enables to visualize white matter fibers in the brain and can map (trace image) subtle changes in the white matter associated with diseases such as multiple sclerosis and epilepsy, as well as assessing diseases where the brain's wiring is abnormal, such as schizophrenia.
The fractional anisotropy (FA) gives information about the shape of the diffusion tensor at each voxel. The FA is based on the normalized variance of the eigenvalues. The fractional anisotropy reflects differences between an isotropic diffusion and a linear diffusion. The FA range is between 0 and 1 (0 = isotropic diffusion, 1 = highly directional).
The development of new imaging methods and some useful analysis techniques, such as 3-dimensional anisotropy contrast (3DAC) and spatial tracking of the diffusion tensor tractography (DTT), are currently under study.

(DTT) This technique has been reported on during the last few years and is the most intriguing demonstration that allows for the noninvasive racking of neuronal fiber projections in a living human brain. White matter fiber trajectories are reconstructed throughout the brain by tracking the direction of fastest diffusion, which is assumed to correspond to the longitudinal axis of the tract. Diffusion tensor tractography should provide new insights into white matter integrity, fiber connectivity, surgical planning, and patients prognosis.

See also B-Value.

Images obtained by a diffusion weighted sequence (e.g. the Stejskal-Tanner sequence) reflect the diffusion as an attenuation of signal intensity. The diffusion time is the time elapsed between the leading edges of the diffusion gradient lobes of this sequence.

(DWI) Magnetic resonance imaging is sensitive to diffusion, because the diffusion of water molecules along a field gradient reduces the MR signal. In areas of lower diffusion the signal loss is less intense and the display from this areas is brighter. The use of a bipolar gradient pulse and suitable pulse sequences permits the acquisition of diffusion weighted images (images in which areas of rapid proton diffusion can be distinguished from areas with slow diffusion).
Based on echo planar imaging, multislice DWI is today a standard for imaging brain infarction. With enhanced gradients, the whole brain can be scanned within seconds. The degree of diffusion weighting correlates with the strength of the diffusion gradients, characterized by the b-value, which is a function of the gradient related parameters: strength, duration, and the period between diffusion gradients.
Certain illnesses show restrictions of diffusion, for example demyelinization and cytotoxic edema. Areas of cerebral infarction have decreased apparent diffusion, which results in increased signal intensity on diffusion weighted MRI scans. DWI has been demonstrated to be more sensitive for the early detection of stroke than standard pulse sequences and is closely related to temperature mapping.
DWIBS is a new diffusion weighted imaging technique for the whole body that produces PET-like images. The DWIBS sequence has been developed with the aim to detect lymph nodes and to differentiate normal and hyperplastic from metastatic lymph nodes. This may be possible caused by alterations in microcirculation and water diffusivity within cancer metastases in lymph nodes.

See also Diffusion Weighted Sequence, Perfusion Imaging, ADC Map, Apparent Diffusion Coefficient, and Diffusion Tensor Imaging.

Diffusion weighted imaging can be performed similar to the phase contrast angiography sequence. The gradients must be increased in amplitude to depict the much slower motions of molecular diffusion in the body.
While a T1 weighted MRI pulse sequence is diffusion sensitive, a quantitative diffusion pulse sequence was introduced by Steijskal and Tanner. Its characteristic features are two strong symmetrical gradient lobes placed on either side of the 180° refocusing pulse in a spin echo sequence. These symmetrical gradient lobes have the sole purpose of enhancing dephasing of spins, thereby accelerating intravoxel incoherent motion (IVIM) signal loss.
Dephasing is proportional to the square of the time (diffusion time) during which the gradients are switched on and the strength of the applied gradient field. Therefore, the use of high field gradient systems with faster and more sensitive sequences, make diffusion weighting more feasible.
Areas in which the protons diffuse rapidly (swollen cells in early stroke, less restriction to diffusion) will show an increased signal when the echo is measured relative to areas in which diffusion is restricted. For increased accuracy of diffusion measurement and image enhancement, useful motion correction techniques such as navigator echo and other methods should be used. In addition to this, applying the b-value calculated by the strength and duration of motion probing gradients with a high rate of accuracy is very important.

See also Apparent Diffusion Coefficient, ADC Map, Lattice Index Map.