ArticleStroke (Hoboken, N.J.)2025
DWI Positivity in Mild, Nondisabling Acute Cerebral Ischemia: Data From the PRISMS Trial.
Article in Stroke (Hoboken, N.J.), 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
What it found
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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
1 citing paper in PubMed.
- Limitations and Blind Spots of Diffusion-Weighted Imaging in the Evaluation of Acute Brain Ischemia: A Narrative Review.Journal of clinical medicine · 2026Review
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Authors and funding
14 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: In patients with acute cerebral ischemia (ACI) and mild deficit, acute infarction on magnetic resonance imaging (diffusion-weighted imaging [DWI]-positivity) is inconsistently detected. Our objective was to characterize the rate of detection in the first dedicated trial of a population with mild, nondisabling stroke and assess the detection and its association with baseline clinical and imaging characteristics. We hypothesized that white matter hyperintensity (WMH) would independently predispose patients to DWI-positivity. Methods: The phase 3b, randomized, double-blinded PRISMS (Potential of Alteplase for Ischemic Strokes with Mild Symptoms) trial compared administration of intravenous alteplase to aspirin for mild (National Institutes of Health Stroke Scale score 0-5), nondisabling stroke at ≤3 hours from onset. For the current, prespecified study, patients with a final diagnosis of neurovascular mimic were excluded. Central readers, blinded to the treatment arm, assessed day 2 magnetic resonance imaging for prior infarct, WMH burden (graded quantitatively [volume] and qualitatively [(Fazekas]), and presence of DWI-positivity (primary outcome). Alteplase treatment, demographics, and clinical covariates were prespecified for adjustment in regression modeling. Results: Of 313 patients enrolled, 273 (87%) had a final diagnosis of ACI. Of 212 (77%) cases of ACI with magnetic resonance imaging, 109 (51%) had DWI positivity (median lesion volume 1.20 cc, interquartile range 0.57-2.50 cc). Univariately, the proportion with higher Fazekas grade (grade 2-3: 27% vs 41%; Conclusions: Among patients presenting with mild, nondisabling ACI, WMH is not associated with DWI-positivity. A hypothesis emerges that alteplase treatment may reduce DWI positivity in mild, nondisabling ACI.
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