Can CT be as good as MRI for detecting ischemic brain lesions?

Perhaps.

Limited evidence in this small study suggests that the utility of head CT, when performed with CT perfusion, may be equal to that of MRI in hyperacute stroke evaluation.


Source

Oliveira-Filho, J. and Koroshetz, W. "Neuroimaging of acute ischemic stroke" Up to Date. 2 June 2009.

Schramm, P. et al. "Comparison of Perfusion Computed Tomography and Computed Tomography Angiography Source Images with Perfusion-Weighted Imaging and Diffusion-Weighted Imaging in Patients With Acute Stroke of Less than 6 Hours Duration" Stroke. 20 May 2004.
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