Does Diffusion-Weighted Imaging Represent the Ischemic Core?
GROUND AND PURPOSE: Diffusion-weighted imaging (DWI) hyperintensity is hypothesized to represent irreversibly infracted tissue (ischemic core) in the setting of acute stroke. Measurement of the ischemic core has implications for both prognosis and therapy. We wished to assess the level of evidence in the literature supporting this hypothesis. MATERIALS AND METHODS: We performed a systematic review of the literature relating to tissue outcomes of DWI hyperintense stroke lesions in humans. The methodologic rigor of studies was evaluated by using criteria set out by the Oxford Centre for Evidence-Based Medicine. Data from individual studies were also analyzed to determine the prevalence of patients demonstrating lesion progression, no change, or lesion regression compared with follow-up imaging. RESULTS: Limited numbers of highly methodologically rigorous studies (Oxford levels 1 and 2) were available. There was great variability in observed rates of DWI lesion reversal (0%–83%), with a s
Related Questions
- Are there features on imaging or core biopsy that can predict tumour-positive margins after breast-conserving surgery?
- Do transient ischemic attacks with diffusion-weighted imaging abnormalities correspond to brain infarctions?
- Is early ischemic lesion volume on diffusion-weighted imaging an independent predictor of stroke outcome?
