Chang Wei-Lun, Lai Ji-Ching, Chen Rong-Fu, Hu Han-Hwa, Pan Chau-Shiung
Department of Neurology, Chang Hua Show Chwan Memorial Hospital, Changhua, Taiwan.
Research Assistant Center, Chang Hua Show Chwan Health Care System, Changhua, Taiwan.
Am J Case Rep. 2017 Jan 23;18:76-79. doi: 10.12659/ajcr.901691.
BACKGROUND Acute ischemic stroke is a major cause of mortality and morbidity in Taiwan. Diffusion-weighted image (DWI) is a sensitive and common strategy used for imaging acute ischemic stroke. CASE REPORT We present a case of a negative DWI MRI for detecting acute ischemic stroke in a clinical setting. A 75-year-old male had a DWI performed after onset of symptoms suggesting acute ischemic stroke. The initial DWI result was negative at 72 hours of presentation. The neurological symptoms of the patient persisted and DWI was repeated. After 14 days, the DWI data confirmed and demonstrated an acute ischemic stroke. The delay in DWI confirmation, from symptom onset until DWI diagnosis, was 336 hours. CONCLUSIONS DWI may not have 100% sensitivity and accuracy in early stages of acute ischemic stroke. The time course to the development of abnormalities detected by DWI may be longer than anticipated.
急性缺血性中风是台湾地区死亡和发病的主要原因。扩散加权成像（DWI）是用于急性缺血性中风成像的一种敏感且常用的方法。
我们报告一例在临床环境中DWI MRI检测急性缺血性中风呈阴性的病例。一名75岁男性在出现提示急性缺血性中风的症状后进行了DWI检查。初次DWI结果在就诊72小时时为阴性。患者的神经症状持续存在，于是重复进行DWI检查。14天后，DWI数据证实并显示为急性缺血性中风。从症状发作到DWI诊断的DWI确认延迟为336小时。
DWI在急性缺血性中风早期可能不具有100%的敏感性和准确性。DWI检测到异常发展的时间进程可能比预期的更长。
