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Related Experiment Video

Updated: Jun 24, 2026

A Magnetic Resonance Imaging Protocol for Stroke Onset Time Estimation in Permanent Cerebral Ischemia
09:59

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Published on: September 16, 2017

Does diffusion-weighted imaging represent the ischemic core? An evidence-based systematic review.

P G Kranz1, J D Eastwood

  • 1Department of Radiology, Duke University Medical Center, Durham, NC 27710, USA. peter.kranz@duke.edu

AJNR. American Journal of Neuroradiology
|April 10, 2009
PubMed
Summary
This summary is machine-generated.

Diffusion-weighted imaging (DWI) hyperintensity in acute stroke may not reliably indicate irreversible infarct core. Evidence is inconsistent, with significant lesion reversal observed in many patients, questioning its prognostic and therapeutic utility.

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Area of Science:

  • Neuroimaging
  • Stroke Research
  • Clinical Neurology

Background:

  • Diffusion-weighted imaging (DWI) hyperintensity is commonly used to identify the ischemic core in acute stroke.
  • Accurate measurement of the ischemic core is crucial for patient prognosis and treatment decisions.

Purpose of the Study:

  • To systematically review the literature evaluating the relationship between DWI hyperintensity and actual tissue outcomes in human stroke.
  • To assess the strength of evidence supporting DWI as a surrogate marker for the irreversible ischemic core.

Main Methods:

  • Systematic literature review of studies on tissue outcomes of DWI lesions in human stroke.
  • Evaluation of study methodological rigor using Oxford Centre for Evidence-Based Medicine criteria.
  • Analysis of individual study data on lesion progression, stability, or regression.

Main Results:

  • A limited number of high-quality studies (Oxford levels 1 and 2) were identified.
  • Observed rates of DWI lesion reversal varied widely (0%-83%), with a pooled mean reversal rate of 24%.
  • Many studies lacked sufficient data to precisely quantify lesion growth or reversal.

Conclusions:

  • The evidence linking DWI hyperintensity to the irreversible ischemic core in humans is inconsistently reported.
  • The current evidence supporting DWI as a reliable surrogate marker for the ischemic core is weak, meriting a Grade D rating.
  • Further rigorous research is needed to clarify the prognostic and therapeutic implications of DWI findings in acute stroke.