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Clinical experience with diffusion-weighted MR in patients with acute stroke
K O Lövblad1, H J Laubach, A E Baird
1Department of Radiology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Mass, USA.
AJNR. American Journal of Neuroradiology
|July 22, 1998
Summary
Echo-planar diffusion-weighted MR imaging shows high sensitivity and specificity for diagnosing acute cerebral infarction. However, negative scans do not entirely rule out an ischemic cause.
Area of Science:
- Radiology
- Neurology
- Medical Imaging
Background:
- Acute ischemic stroke diagnosis relies on timely and accurate imaging.
- Diffusion-weighted MR imaging (DW-MRI) offers potential for early detection of infarction.
Purpose of the Study:
- To evaluate the clinical efficacy, sensitivity, and specificity of echo-planar diffusion-weighted MR imaging for acute infarction.
- To assess the diagnostic performance of DW-MRI in acute ischemic stroke.
Main Methods:
- Retrospective analysis of 194 patients with acute ischemic stroke diagnosed within 24 hours.
- Utilized echo-planar diffusion-weighted MR imaging with high and low b values.
- Clinical diagnosis of acute stroke served as the reference standard.
Main Results:
- DW-MRI demonstrated 88% sensitivity and 95% specificity for infarction.
- Positive predictive value was 98.5%, negative predictive value was 69.5%.
- Sensitivity increased to 94% and specificity to 100% when analyzed within 6 hours of onset.
Conclusions:
- Echo-planar DW-MRI exhibits high sensitivity and specificity in diagnosing acute cerebral infarction.
- Negative DW-MRI findings do not exclude an ischemic pathogenesis.
- DW-MRI is a valuable tool for acute stroke evaluation.