Diffusion weighted imaging (DWI) for stroke
Evidence-based neurology checklist on diffusion weighted imaging (dwi) for stroke: Stroke features This shows acute infarct as restricted diffusion: it is hyperintense DWI is usually positive for weeks It gives the most accurate diagnosis but it is falsely negative in about 6-33% of cases False…
Stroke features
- This shows acute infarct as restricted diffusion: it is hyperintense
- DWI is usually positive for weeks
- It gives the most accurate diagnosis but it is falsely negative in about 6-33% of cases
- False negative DWI is more likely with posterior circulation stroke
- Younger females are also more likely to have false negative DWI scans
Differentials of restricted diffusion on DWI
Significance of baseline DWI lesion volume
Clinical-DWI mismatch
MRI fogging effect
References
- Schellinger PD, Bryan RN, Caplan LR, et al. Evidence-based guideline: the role of diffusion and perfusion MRI for the diagnosis of acute ischemic stroke. Report of the Therapeutics and Technology Assessment Subcommittee of the American Academy of Neurology. Neurology 2010; 75:177-185.
- Warren DJ, Musson R, Connolly DJA, Griffiths PD, Hoggard N. Imaging in acute ischaemic stroke: essential for modern stroke care. Postgrad Med J 2010; 86:409-418.
- Davalos A, Blanco M, Pedraza S, et al. The clinical-DWI mismatch: a new diagnostic approach to the brain tissue at risk of infarction. Neurology 2004; 62:2187-2192.
- Oppenheim C, Stanescu R, Dormont D, et al. False-negative diffusion-weighted MR findings in acute ischemic stroke. Am J Neuroradiol 2000; 21:1434-1440.
- Simonsen CZ, Madsen MH, Schmitz ML, Mikkelsen IK, Fisher M, Andersen G. Sensitivity of diffusion- and perfusion-weighted imaging for diagnosing acute ischemic stroke is 97.5%. Stroke 2015; 46:98-101.
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