The prelims comprise: DSCE MRI perfusion captures the first pass of an intravenously injected paramagnetic contrast agent. The T2 (SE) or T2* (GE) signal drop is measured to create a time versus intensity curve which are then converted to a time versus concentration curve. The detection of the penumbra during the acute stroke with DSCE MRI perfusion can guide the clinical conduct toward thrombolysis, clot removal or expectant management. The DSCE MRI perfusion characteristics of brain tumors help answer the neuroradiologist's questions about differential diagnosis, grading, and guide management and biopsy site. DSCE MRI perfusion matches the metabolic alterations present in patients with epilepsy and can lateralize the epileptogenic focus, especially in mesial temporal sclerosis. DSCE MRI can be helpful in the distinction between tumor and tumor-like lesions due to the detection of angiogenesis in tumors. DSCE MRI has potential value in the assessment of response to treatment in high grade gliomas, where conventional MRI significance is limited.