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Related Experiment Video

Updated: Aug 20, 2025

A Magnetic Resonance Imaging Protocol for Stroke Onset Time Estimation in Permanent Cerebral Ischemia
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Diffusion kurtosis imaging in patients with tissue-negative transient ischemic attack.

Jia Zhou1, Rui He1, Xiaoyu Xu1

  • 1Department of Radiology, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.

Frontiers in Neurology
|November 24, 2022
PubMed
Summary

Diffusion kurtosis imaging (DKI) detects abnormalities in patients with transient ischemic attack (TIA) who have normal diffusion-weighted imaging (DWI) scans. DKI findings predict recurrent stroke in these TIA patients.

Keywords:
diffusion kurtosis imagingdiffusion-weighted imagingischemic stroketissue-negativetransient ischemic attack

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Area of Science:

  • Neurology
  • Radiology
  • Medical Imaging

Background:

  • Transient ischemic attack (TIA) diagnosis can be challenging, with many patients lacking evidence on conventional diffusion-weighted imaging (DWI).
  • This diagnostic gap necessitates advanced imaging techniques to identify at-risk individuals.

Purpose of the Study:

  • To evaluate the additional diagnostic value of diffusion kurtosis imaging (DKI) in TIA patients with normal DWI findings.
  • To determine if DKI can predict stroke recurrence in this patient cohort.

Main Methods:

  • Prospective study of 179 suspected TIA patients undergoing MRI (DWI and DKI) within 24 hours of symptom onset.
  • Included patients had confirmed TIA, no stroke history, and no DWI lesions at baseline.
  • Follow-up DWI was performed within 90 days to assess stroke recurrence.

Main Results:

  • Of 98 patients with normal baseline DWI, 31 (31.6%) showed positive findings on DKI.
  • DKI abnormalities correlated with clinical symptoms in 93.5% of positive cases.
  • Recurrent stroke occurred in 14.3% of patients; it was significantly higher in the DKI-positive group (29.0% vs. 7.5%, p=0.01).
  • Baseline DKI abnormality was associated with stroke recurrence, with 8 of 9 DKI-positive stroke patients developing new lesions in the corresponding arterial territory.

Conclusions:

  • Diffusion kurtosis imaging (DKI) offers significant added diagnostic value in TIA patients with normal DWI.
  • DKI findings can predict the risk of recurrent stroke in TIA patients with initially negative DWI scans.
  • DKI may help identify TIA patients who require closer monitoring or more aggressive management to prevent future strokes.