Trial reportJournal of cerebral blood flow and metabolism : official journal of the International Society of Cerebral Blood Flow and Metabolism2012
The infarct core is well represented by the acute diffusion lesion: sustained reversal is infrequent.
Trial report in Journal of cerebral blood flow and metabolism : official journal of the International Society of Cerebral Blood Flow and Metabolism, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 78 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
78 citing papers in PubMed, 1 synthesis or guideline pooled it, 195 citations in OpenAlex.
- Standards and pitfalls of focal ischemia models in spontaneously hypertensive rats: with a systematic review of recent articles.Journal of translational medicine · 2012Pooled it
- Intravenous Glyburide in Medical and Endovascular-Treated Large-Core Stroke: A Subgroup Analysis of the CHARM Randomized Clinical Trial.Annals of neurology · 2025Trial
- A multicenter randomized controlled trial of endovascular therapy following imaging evaluation for ischemic stroke (DEFUSE 3).International journal of stroke : official journal of the International Stroke Society · 2017Trial
- Spectroscopy of reperfused tissue after stroke reveals heightened metabolism in patients with good clinical outcomes.Journal of cerebral blood flow and metabolism : official journal of the International Society of Cerebral Blood Flow and Metabolism · 2014Trial
- DWI reversal is associated with small infarct volume in patients with TIA and minor stroke.AJNR. American journal of neuroradiology · 2014Trial
- The multiverse of mismatchness in neuroradiology for stroke assessment: a narrative review.European radiology · 2026Review
- Beyond Conventional Imaging: From Time-Based to Data-Driven Decision-Making in Acute Ischemic Stroke.Journal of atherosclerosis and thrombosis · 2026Review
- Mapping DWI signal reversal and long-term tissue outcomes following endovascular therapy in acute ischemic stroke.European radiology · 2026Article
- Carrier-Free Rapamycin-Loaded Nanoparticles with MRI and Near-Infrared Fluorescence Bimodal Imaging for Precise Diagnosis and Synergistic Therapy of Ischemic Stroke.International journal of nanomedicine · 2026Article
- Estimation of Acute Infarct Core and Hypoperfused Region from Baseline Noncontrast Computed Tomography and Computed Tomography Angiography Scans of Patients with Ischemic Stroke.Stroke (Hoboken, N.J.) · 2025Article
- DWI Reversibility in Acute Ischemic Stroke Due to Basilar Artery Occlusion Following Successful Recanalization.Clinical neuroradiology · 2025Observational
- Reversibility of diffuse magnetic resonance imaging following endovascular therapy in acute ischemic stroke: a systematic review and meta-analysis.Quantitative imaging in medicine and surgery · 2025Article
- Development of an MRI based artificial intelligence model for the identification of underlying atrial fibrillation after ischemic stroke: a multicenter proof-of-concept analysis.EClinicalMedicine · 2025Article
- Hyperacute ischemic stroke care-Current treatment and future directions.International journal of stroke : official journal of the International Stroke Society · 2024Review
- Imaging in acute ischaemic stroke: assessing findings in light of evolving therapies.The British journal of radiology · 2024Review
- Long-Term Effect of Mechanical Thrombectomy in Stroke Patients According to Advanced Imaging Characteristics.Clinical neuroradiology · 2024Article
- A comprehensive review for artificial intelligence on neuroimaging in rehabilitation of ischemic stroke.Frontiers in neurology · 2024Review
- Automated advanced imaging in acute ischemic stroke. Certainties and uncertainties.European journal of radiology open · 2023Article
- The role of input imaging combination and ADC threshold on segmentation of acute ischemic stroke lesion using U-Net.European radiology · 2023Article
- The Iodinated Contrast Crisis of 2022: A Near Miss or a Missed Opportunity?AJNR. American journal of neuroradiology · 2023Article
18 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
16 authors at 6 institutions in 3 countries.
Funding
Abstract
Diffusion-weighted imaging (DWI) is commonly used to assess irreversibly infarcted tissue but its accuracy is challenged by reports of diffusion lesion reversal (DLR). We investigated the frequency and implications for mismatch classification of DLR using imaging from the EPITHET (Echoplanar Imaging Thrombolytic Evaluation Trial) and DEFUSE (Diffusion and Perfusion Imaging Evaluation for Understanding Stroke Evolution) studies. In 119 patients (83 treated with IV tissue plasminogen activator), follow-up images were coregistered to acute diffusion images and the lesions manually outlined to their maximal visual extent in diffusion space. Diffusion lesion reversal was defined as voxels of acute diffusion lesion that corresponded to normal brain at follow-up (i.e., final infarct, leukoaraiosis, and cerebrospinal fluid (CSF) voxels were excluded from consideration). The appearance of DLR was visually checked for artifacts, the volume calculated, and the impact of adjusting baseline diffusion lesion volume for DLR volume on perfusion-diffusion mismatch analyzed. Median DLR volume reduced from 4.4 to 1.5 mL after excluding CSF/leukoaraiosis. Visual inspection verified 8/119 (6.7%) with true DLR, median volume 2.33 mL. Subtracting DLR from acute diffusion volume altered perfusion-diffusion mismatch (T(max)>6 seconds, ratio>1.2) in 3/119 (2.5%) patients. Diffusion lesion reversal between baseline and 3 to 6 hours DWI was also uncommon (7/65, 11%) and often transient. Clinically relevant DLR is uncommon and rarely alters perfusion-diffusion mismatch. The acute diffusion lesion is generally a reliable signature of the infarct core.
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.