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Brief Report

Accuracy of Diffusion-Weighted Imaging in the Diagnosis of Stroke in Patients With Suspected Cerebral Infarct

Alejandro M. Brunser, Arnold Hoppe, Sergio Illanes, Violeta Díaz, Paula Muñoz, Daniel Cárcamo, Verónica Olavarria, Marcela Valenzuela, Pablo Lavados
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https://doi.org/10.1161/STROKEAHA.111.000527
Stroke. 2013;44:1169-1171
Originally published March 25, 2013
Alejandro M. Brunser
From the Cerebrovascular Program, Neurology Service, Department of Internal Medicine Clínica Alemana de Santiago, Facultad de Medicina, Universidad del Desarrollo, Santiago, Chile (A.M.B., A.H., S.I., V.D., P.M., D.C., V.O., M.V., P.L.).
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Arnold Hoppe
From the Cerebrovascular Program, Neurology Service, Department of Internal Medicine Clínica Alemana de Santiago, Facultad de Medicina, Universidad del Desarrollo, Santiago, Chile (A.M.B., A.H., S.I., V.D., P.M., D.C., V.O., M.V., P.L.).
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Sergio Illanes
From the Cerebrovascular Program, Neurology Service, Department of Internal Medicine Clínica Alemana de Santiago, Facultad de Medicina, Universidad del Desarrollo, Santiago, Chile (A.M.B., A.H., S.I., V.D., P.M., D.C., V.O., M.V., P.L.).
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Violeta Díaz
From the Cerebrovascular Program, Neurology Service, Department of Internal Medicine Clínica Alemana de Santiago, Facultad de Medicina, Universidad del Desarrollo, Santiago, Chile (A.M.B., A.H., S.I., V.D., P.M., D.C., V.O., M.V., P.L.).
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Paula Muñoz
From the Cerebrovascular Program, Neurology Service, Department of Internal Medicine Clínica Alemana de Santiago, Facultad de Medicina, Universidad del Desarrollo, Santiago, Chile (A.M.B., A.H., S.I., V.D., P.M., D.C., V.O., M.V., P.L.).
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Daniel Cárcamo
From the Cerebrovascular Program, Neurology Service, Department of Internal Medicine Clínica Alemana de Santiago, Facultad de Medicina, Universidad del Desarrollo, Santiago, Chile (A.M.B., A.H., S.I., V.D., P.M., D.C., V.O., M.V., P.L.).
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Verónica Olavarria
From the Cerebrovascular Program, Neurology Service, Department of Internal Medicine Clínica Alemana de Santiago, Facultad de Medicina, Universidad del Desarrollo, Santiago, Chile (A.M.B., A.H., S.I., V.D., P.M., D.C., V.O., M.V., P.L.).
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Marcela Valenzuela
From the Cerebrovascular Program, Neurology Service, Department of Internal Medicine Clínica Alemana de Santiago, Facultad de Medicina, Universidad del Desarrollo, Santiago, Chile (A.M.B., A.H., S.I., V.D., P.M., D.C., V.O., M.V., P.L.).
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Pablo Lavados
From the Cerebrovascular Program, Neurology Service, Department of Internal Medicine Clínica Alemana de Santiago, Facultad de Medicina, Universidad del Desarrollo, Santiago, Chile (A.M.B., A.H., S.I., V.D., P.M., D.C., V.O., M.V., P.L.).
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Abstract

Background and Purpose—The accuracy of diffusion-weighted imaging (DWI) for the diagnosis of acute cerebral ischemia among patients with suspected ischemic stroke arriving to an emergency room has not been studied in depth.

Methods—DWI was performed in 712 patients with acute or subacute focal symptoms that suggested an acute ischemic stroke (AIS), 609 of them with AIS.

Results—DWI demonstrated a sensitivity of 90% and specificity of 97%, a positive likelihood ratio of 31 and a negative likelihood ratio of 0.1 for detecting AIS. The overall accuracy was 95%. Of those patients who demonstrated abnormal DWI studies, 99.5% were AIS patients, and of those patients with normal DWI studies 63% were stroke mimics.

Conclusions—DWI is accurate in detecting AIS in unselected patients with suspected AIS; a negative study should alert for nonischemic conditions.

  • diagnosis
  • diffusion-weighted imaging
  • stroke
  • Received December 16, 2012.
  • Accepted December 26, 2012.
  • © 2013 American Heart Association, Inc.
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    Accuracy of Diffusion-Weighted Imaging in the Diagnosis of Stroke in Patients With Suspected Cerebral Infarct
    Alejandro M. Brunser, Arnold Hoppe, Sergio Illanes, Violeta Díaz, Paula Muñoz, Daniel Cárcamo, Verónica Olavarria, Marcela Valenzuela and Pablo Lavados
    Stroke. 2013;44:1169-1171, originally published March 25, 2013
    https://doi.org/10.1161/STROKEAHA.111.000527

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    Accuracy of Diffusion-Weighted Imaging in the Diagnosis of Stroke in Patients With Suspected Cerebral Infarct
    Alejandro M. Brunser, Arnold Hoppe, Sergio Illanes, Violeta Díaz, Paula Muñoz, Daniel Cárcamo, Verónica Olavarria, Marcela Valenzuela and Pablo Lavados
    Stroke. 2013;44:1169-1171, originally published March 25, 2013
    https://doi.org/10.1161/STROKEAHA.111.000527
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