Wang Wei, Goldstein Steven, Scheuer Mark L, Branstetter Barton F
Department of Neurology, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
J Neuroimaging. 2003 Apr;13(2):158-61.
Diffusion-weighted imaging (DWI) is sensitive for the detection of acute ischemic stroke. However, a negative DWI study of the brain does not always exclude a patient from the possibility of acute cerebral ischemia. The authors report 1 case in which the patient presented with a fixed ischemic neurological deficit (National Institute of Health Stroke Scale score = 22) that included global aphasia, right hemiparesis, and a right visual field neglect. The initial DWI of the brain within 27 hours of symptom onset was negative. The deficit persisted, and a repeat magnetic resonance imaging study 7 days later showed a large area of restricted diffusion involving the gray matter of the entire left middle cerebral artery and anterior cerebral artery distribution, indicating a large area of cortical stroke.
扩散加权成像（DWI）对急性缺血性脑卒中的检测很敏感。然而，脑部DWI检查结果为阴性并不总是能排除患者发生急性脑缺血的可能性。作者报告了1例患者，该患者出现了固定的缺血性神经功能缺损（美国国立卫生研究院卒中量表评分为22分），包括完全性失语、右侧偏瘫和右侧视野忽视。症状发作后27小时内进行的初次脑部DWI检查结果为阴性。神经功能缺损持续存在，7天后重复进行的磁共振成像研究显示，大面积扩散受限，累及整个左侧大脑中动脉和大脑前动脉分布区域的灰质，提示大面积皮质卒中。
