Highlights
- •DWI is useful to evaluate stroke mechanism, predict complications and outcome.
- •DWI reversal, DWI negative stroke and DWI stroke mimics are interpretation pitfalls.
- •Reversal of DWI lesion occurs in 26.5% of stroke and associated with reperfusion.
- •DWI negative stroke is noted in 6.8% to 21% of clinically diagnosed stroke.
Abstract
Diffusion weighted imaging (DWI) is a widely used imaging technique to evaluate patients
with stroke. It can detect brain ischemia within minutes of stroke onset. However,
DWI has few potential pitfalls that should be recognized during interpretation. DWI
lesion could be reversible in the early hours of stroke and the entire lesion may
not represent ischemic core. False negative DWI could lead to diagnosis of DWI negative
stroke or to a missed stroke diagnosis. Ischemic stroke mimics can occur on DWI with
non-cerebrovascular neurological conditions. In this article, the history of DWI,
its clinical applications, and potential pitfalls for use in acute ischemic stroke
are reviewed. Advanced diffusion imaging techniques with reference to Diffusion Kurtosis
Imaging and Diffusion Tensor Imaging that has been studied to evaluate ischemic core
are discussed.
Keywords
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Article info
Publication history
Published online: April 03, 2021
Accepted:
April 2,
2021
Received in revised form:
March 8,
2021
Received:
December 24,
2020
Identification
Copyright
© 2021 Elsevier B.V. All rights reserved.
