Related Experiment Video
Updated: Apr 16, 2026
Brain Infarct Segmentation and Registration on MRI or CT for Lesion-symptom Mapping
Published on: September 25, 2019
A retrospective analysis of negative diffusion-weighted image results in patients with acute cerebral infarction
Lian Zuo1, Yue Zhang1, Xiahong Xu1
1Department of Neurology, East Hospital, Tongji University, Shanghai 200120, China.
Abstract:
We aimed to investigate the clinicoradiologic determinants of negative diffusion-weighted image (DWI) results in patients with acute cerebral infarction (ACI). The medical records were reviewed of ACI patients. Patients were divided to the DWI positive and negative group. Positive DWI was used as independent variable and patients' clinicoradiologic factors were used as co-variables for multivariate logistic regression analysis. 349 patients received initial cerebral MRI within 72 hours of admission. Lacunar infarction was most common (42.1%) followed by posterior circulation infarction (30.1%) and partial anterior circulation infarction (18.1%). The majority of the patients (72.2%) had an NIHSS score of less than 5 at admission. 316 patients (90.54%) were positive on initial DWI. Patients with smoking, initial SBP ≥ 140 or DBP ≥ 90 mmHg, initial fasting plasma glucose (FPG) ≥ 7.0 mmol/L, initial MRI from onset of disease >1 d and anterior circulation infarction were liable to show positive DWI. Furthermore, DWI negative patients had significantly lower NIHSS scores (IQR 0,1,2) than DWI positive patients (IQR 1,2,4) (P = 0.000) at two weeks post onset of acute cerebral infarction. In conclusion, multiple clinicoradiologic factors are associated with negative and positive DWI and further delineation of these factors is required in future prospective studies.
Insights
Negative diffusion-weighted imaging (DWI) in acute cerebral infarction (ACI) is linked to specific patient factors. Understanding these determinants aids in interpreting DWI results for stroke diagnosis.
Area of Science:
- Neurology
- Radiology
- Medical Imaging
Background:
- Diffusion-weighted imaging (DWI) is crucial for diagnosing acute cerebral infarction (ACI).
- Identifying factors associated with negative DWI results is important for accurate clinical interpretation.
- Previous studies have not fully elucidated the clinicoradiologic determinants of negative DWI in ACI.
Purpose of the Study:
- To investigate the clinicoradiologic factors associated with negative diffusion-weighted image (DWI) results in patients diagnosed with acute cerebral infarction (ACI).
Main Methods:
- Retrospective review of medical records for ACI patients who underwent initial cerebral MRI within 72 hours of admission.
- Patients were categorized into DWI-positive and DWI-negative groups.
- Multivariate logistic regression analysis was employed to identify clinicoradiologic determinants of positive DWI.
Main Results:
- Out of 349 patients, 90.54% showed positive DWI results.
- Factors associated with positive DWI included smoking, elevated blood pressure (SBP ≥ 140 or DBP ≥ 90 mmHg), high fasting plasma glucose (FPG ≥ 7.0 mmol/L), anterior circulation infarction, and MRI timing >1 day from onset.
- DWI-negative patients had significantly lower National Institutes of Health Stroke Scale (NIHSS) scores at two weeks post-onset compared to DWI-positive patients.
Conclusions:
- Multiple clinicoradiologic factors are significantly associated with both positive and negative DWI findings in acute cerebral infarction.
- Further prospective studies are needed to comprehensively delineate these factors and their clinical implications.
