OBJECTIVE To determine the diagnostic value of acute infarcts in multiple cerebral circulations (AIMCC) on MRI diffusion-weighted imaging (DWI) for cardioembolism (CE) stroke subtype in adult patients hospitalized with acute ischemic stroke, we conducted a systematic literature review and meta-analysis. METHODS MEDLINE was searched via PubMed for articles reporting patients hospitalized with acute ischemic stroke with MRI DWI categorized as AIMCC vs other and use of Trial of Org 10172 in Acute Stroke Treatment (TOAST) Criteria for cardioembolism subtype. Measures of diagnostic accuracy were calculated from the retrieved studies. RESULTS Seven eligible articles comprised 5813 patients. Bivariate random effects models estimated sensitivity 0.19 (95% CI, 0.13 to 0.27), specificity 0.89 (0.86 to 0.91), positive predictive value 0.37 (0.30 to 0.45), negative predictive value 0.76 (0.7 to 0.82), positive likelihood ratio 1.70 (1.13 to 2.57) and negative likelihood ratio 0.91 (0.83 to 1). INTERPRETATION The pattern of AIMCC on DWI is of limited diagnostic value. It is not sufficiently accurate to exclude cardiac pathology by a negative test nor does a positive test indicate a major increase in the probability of identifying a potential cardioembolic source.

中文翻译：

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心血管栓塞性卒中多发性脑梗死急性梗死的诊断准确性：文献综述和荟萃分析。

目的为了确定多发性脑循环急性梗塞（AIMCC）对住院的急性缺血性卒中成年患者的MRI弥散加权成像（DWI）对心脏栓塞（CE）中风亚型的诊断价值，我们进行了系统的文献综述和荟萃分析分析。方法通过PubMed搜索MEDLINE，以报告报道患有急性缺血性卒中，MRI DWI分类为AIMCC与其他的MRI DWI以及使用Org 10172试验在急性卒中治疗（TOAST）标准中用于心脏栓塞亚型的患者的文章。从检索到的研究中计算出诊断准确性的量度。结果七篇符合条件的文章包括5813例患者。双变量随机效应模型估算的敏感性为0.19（95％CI，0.13至0.27），特异性0.89（0.86至0.91），阳性预测值0.37（0.30至0.45），负预测值0.76（0.7至0.82），正似然比1.70（1.13至2.57）和负似然比0.91（0.83至1）。解释DWI上的AIMCC模式具有有限的诊断价值。通过阴性试验排除心脏病理是不够准确的，阳性试验也没有表明识别潜在心脏栓塞源的可能性大大增加。