{
  "abstract": "Background: Diffusion-weighted imaging (DWI) is central to acute ischemic stroke (AIS) management; however, its performance varies across different clinical applications. This systematic review and meta-analysis comprehensively evaluated the diagnostic accuracy, time window estimation capability, and prognostic value of DWI in AIS.\n\nMethods: This registered systematic review searched three major databases for DWI studies in adult AIS patients published from 2010 to 2025. Risk of bias was assessed using QUADAS-2. The meta-analysis was performed in three distinct phases: (1) diagnostic accuracy, (2) time window estimation, and (3) prognostic value using a bivariate random-effects model. Extensive subgroup analyses were conducted to investigate sources of heterogeneity, including AI assistance, MRI field strength, study design, onset-to-DWI time, sequence type, lesion location, and stroke severity.\n\nResults: Of 34 eligible studies, 22 independent studies with 30 datasets were included in the meta-analysis across three phases. DWI demonstrated excellent diagnostic accuracy with a pooled sensitivity of 0.912 (95% CI: 0.888–0.932) and specificity of 0.959 (95% CI: 0.940–0.970). For time window estimation, DWI showed moderate performance with a pooled sensitivity of 0.786 (95% CI: 0.688–0.860) and specificity of 0.727 (95% CI: 0.668–0.780), with substantial heterogeneity and markedly lower accuracy in posterior circulation strokes. DWI-derived biomarkers demonstrated good prognostic value for predicting functional outcomes with a pooled sensitivity of 0.702 (95% CI: 0.540–0.825) and specificity of 0.904 (95% CI: 0.821–0.951).\n\nConclusion: DWI offers excellent diagnostic accuracy for AIS (sensitivity: 0.912, specificity: 0.959) but only modest performance for time estimation (sensitivity: 0.786, specificity: 0.727). DWI-derived biomarkers show good prognostic value (sensitivity: 0.702, specificity: 0.904), while AI and ultra-fast MRI protocols demonstrate promise for improving clinical utility.\n\nStudy design: Registered systematic review and meta-analysis following PRISMA guidelines\n\nPROSPERO registration: 2026 CRD420261376477.\n\nSupplementary Information: The online version contains supplementary material available at https://doi.org/10.1186/s12880-026-02592-w.",
  "abstract_shown": true,
  "affiliations": [
    "Magnetic Resonance, Zhongshan Hospital Affiliated to Xiamen University, 201-209 Hubin South Road, Siming District, Xiamen City, Fujian Province 361004 China",
    "Department of Radiology, Zhongshan Hospital Affiliated to Xiamen University, 201-209 Hubin, South Road, Siming District, Xiamen City, Fujian Province 361004 China"
  ],
  "article_type": "review article",
  "arxiv": null,
  "author_total": 2,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Yueqin Wang"
    },
    {
      "affs": [
        1
      ],
      "name": "LuXin Guo"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/8zmw37ktjnbbz.bib",
  "cited_by": 0,
  "doi": "10.1186/s12880-026-02592-w",
  "fulltext_url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC13711878/",
  "id": "8zmw37ktjnbbz",
  "issns": [
    "1471-2342"
  ],
  "landing_url": "https://doi.org/10.1186/s12880-026-02592-w",
  "language": "en",
  "licence": "CC-BY-NC-ND-4.0",
  "licence_label": "CC BY-NC-ND 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by-nc-nd/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "Systematic Review"
    ],
    [
      "lcc",
      "R855-855.5"
    ],
    [
      "openalex",
      "2713|Acute Ischemic Stroke Management"
    ]
  ],
  "openalex": "W7171843349",
  "pdf_url": null,
  "pmcid": "PMC13711878",
  "pmid": "42934575",
  "published": "2026-07-01",
  "publisher": "BMC",
  "ris": "https://research.draconitic.com/paper/8zmw37ktjnbbz.ris",
  "sources": [
    {
      "first_seen": "2026-10-31T12:22:34Z",
      "native_id": "PMC13711878",
      "source": "pmc",
      "url": "https://doi.org/10.1186/s12880-026-02592-w"
    },
    {
      "first_seen": "2026-11-01T14:21:25Z",
      "native_id": "0c3a3a482b914c0380178dc4cfa2c6be",
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      "url": "https://doi.org/10.1186/s12880-026-02592-w"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2713|Acute Ischemic Stroke Management",
      "subfield": "epidemiology-public-health"
    }
  ],
  "title": "Diagnostic accuracy, time window estimation, and prognostic value of diffusion-weighted MRI in acute ischemic stroke: a systematic review and meta-analysis",
  "title_text": "Diagnostic accuracy, time window estimation, and prognostic value of diffusion-weighted MRI in acute ischemic stroke: a systematic review and meta-analysis",
  "type": "peer-reviewed",
  "updated_at": "2026-11-03T14:20:52Z",
  "url": "https://research.draconitic.com/paper/8zmw37ktjnbbz",
  "venue": "BMC Medical Imaging",
  "versions": []
}