title: A retrospective analysis of negative diffusion-weighted image results in patients with acute cerebral infarction.
abstract: We aimed to investigate the clinicoradiologic determinants of negative diffusion-weighted image (DWI) results in patients with acute cerebral infarction (ACI). The medical records were reviewed of ACI patients. Patients were divided to the DWI positive and negative group. Positive DWI was used as independent variable and patients' clinicoradiologic factors were used as co-variables for multivariate logistic regression analysis. 349 patients received initial cerebral MRI within 72 hours of admission. Lacunar infarction was most common (42.1%) followed by posterior circulation infarction (30.1%) and partial anterior circulation infarction (18.1%). The majority of the patients (72.2%) had an NIHSS score of less than 5 at admission. 316 patients (90.54%) were positive on initial DWI. Patients with smoking, initial SBP ≥ 140 or DBP ≥ 90 mmHg, initial fasting plasma glucose (FPG) ≥ 7.0 mmol/L, initial MRI from onset of disease >1 d and anterior circulation infarction were liable to show positive DWI. Furthermore, DWI negative patients had significantly lower NIHSS scores (IQR 0,1,2) than DWI positive patients (IQR 1,2,4) (P = 0.000) at two weeks post onset of acute cerebral infarction. In conclusion, multiple clinicoradiologic factors are associated with negative and positive DWI and further delineation of these factors is required in future prospective studies.
authors.affiliation: Department of Neurology, East Hospital, Tongji University, Shanghai 200120, China.
authors.forename: Lian
authors.initials: L
authors.lastname: Zuo
authors.affiliation: Department of Neurology, East Hospital, Tongji University, Shanghai 200120, China.
authors.forename: Yue
authors.initials: Y
authors.lastname: Zhang
authors.affiliation: Department of Neurology, East Hospital, Tongji University, Shanghai 200120, China.
authors.forename: Xiahong
authors.initials: X
authors.lastname: Xu
authors.affiliation: Department of Neurology, East Hospital, Tongji University, Shanghai 200120, China.
authors.forename: Ying
authors.initials: Y
authors.lastname: Li
authors.affiliation: Department of Neurology, East Hospital, Tongji University, Shanghai 200120, China.
authors.forename: Huan
authors.initials: H
authors.lastname: Bao
authors.affiliation: Department of Neurology, East Hospital, Tongji University, Shanghai 200120, China.
authors.forename: Junjie
authors.initials: J
authors.lastname: Hao
authors.affiliation: Department of Neurology, Zhongshan Hospital, Fudan University, Shanghai 200032, China.
authors.forename: Xin
authors.initials: X
authors.lastname: Wang
authors.affiliation: Department of Neurology, East Hospital, Tongji University, Shanghai 200120, China.
authors.forename: Gang
authors.initials: G
authors.lastname: Li
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001921:Brain / Q000473:pathology; D002544:Cerebral Infarction / Q000175:diagnosis* / Q000188:drug therapy / Q000209:etiology; D038524:Diffusion Magnetic Resonance Imaging / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D015912:Thrombolytic Therapy; D013997:Time Factors