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Diffusion-Weighted Imaging Superior for Stroke Diagnosis

Last Updated: July 12, 2010.

Diffusion-weighted imaging is accurate and appears to be more useful than noncontrast computed tomography for diagnosing acute ischemic stroke within 12 hours after symptoms appear; however, there is not enough evidence to support or refute the efficacy of perfusion-weighted imaging in diagnosing acute ischemic stroke, according to an analysis published in the July 13 issue of Neurology.

MONDAY, July 12 (HealthDay News) -- Diffusion-weighted imaging (DWI) is accurate and appears to be more useful than noncontrast computed tomography (CT) for diagnosing acute ischemic stroke within 12 hours after symptoms appear; however, there is not enough evidence to support or refute the efficacy of perfusion-weighted imaging (PWI) in diagnosing acute ischemic stroke, according to an analysis published in the July 13 issue of Neurology.

To determine the diagnostic and prognostic values of the two imaging methods, Peter D. Schellinger, M.D., of the National Institutes of Health in Bethesda, Md., and colleagues analyzed literature from 1966 to 2008 regarding the use of DWI and PWI for diagnosing patients with acute ischemic stroke.

Their search indicated that DWI is useful -- more useful, in fact, than noncontrast CT -- for diagnosing acute ischemic stroke within 12 hours of the onset of symptoms, but that the sensitivity of this imaging method is not perfect for diagnosing ischemic stroke in a general population of patients who possibly have acute stroke. Using Class II and III evidence, the researchers determined that baseline DWI volumes likely predict baseline stroke severity in anterior territory stroke but may not do so in vertebrobasilar artery territory stroke. These volumes are also probably predictors of (final) infarct volumes and may be predictors of early and late outcome measures. Little evidence was found to recommend or refute use of PWI for diagnosis of acute ischemic stroke.

"DWI should be considered superior to noncontrast CT scan for the diagnosis of acute ischemic stroke in patients presenting within 12 hours of symptom onset," the authors write. "There is insufficient evidence to support or refute the value of PWI in diagnosing acute ischemic stroke."

The authors disclosed financial ties to pharmaceutical and medical device companies.

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