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Updated: Oct 1, 2025
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A Magnetic Resonance Imaging Protocol for Stroke Onset Time Estimation in Permanent Cerebral Ischemia
Published on: September 16, 2017
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Diffusion-weighted imaging as predictor of acute ischemic stroke etiology
Alejandro Michel Brunser1,2,3, Eloy Mansilla1,3, Victor Navia1,3
1Clínica Alemana de Santiago, Department of Neurology and Psychiatry, Vascular Neurology Service, Neurology Unit, Santiago, Chile.
Arquivos De Neuro-Psiquiatria
|March 3, 2022
Summary
Diffusion-weighted imaging (DWI) patterns correlate with ischemic stroke causes. Specific DWI findings help predict stroke subtypes, aiding in diagnosis and treatment selection for better patient outcomes.
Area of Science:
- Neurology
- Radiology
- Medical Imaging
Background:
- Topographic patterns observed in neuroimaging may indicate the underlying causes of ischemic stroke.
- Understanding these patterns is crucial for accurate stroke classification and management.
Purpose of the Study:
- To investigate the association between diffusion-weighted imaging (DWI) findings and the Trial of Org 10172 in Acute Stroke Treatment (TOAST) classification.
- To determine if DWI patterns can predict specific etiologies of ischemic stroke.
Main Methods:
- A cohort of 1019 ischemic stroke patients was analyzed.
- Diffusion-weighted imaging (DWI) scans were classified into four categories: negative, single lesion, scattered lesions in one territory, and multiple lesions (including MAC, MPC, MBAC, and MAP).
- Statistical analysis was performed to identify correlations between DWI patterns and TOAST classifications.
Main Results:
- A significant relationship (p<0.001) was found between DWI patterns and TOAST classification.
- Specific DWI patterns were associated with different stroke etiologies, including large artery atherosclerosis, cardioembolic stroke, cryptogenic stroke, and lacunar stroke.
- For example, subcortical lesions <20 mm strongly correlated with lacunar strokes (OR 42.9) and large artery atherosclerosis (OR 3.47).
Conclusions:
- A clear relationship exists between diffusion-weighted imaging (DWI) patterns and ischemic stroke subtypes.
- DWI findings can serve as a valuable tool for predicting stroke etiology, potentially improving diagnostic accuracy and guiding therapeutic strategies.
