# Quantitative estimation of intravoxel incoherent motion parameters in acute ischemic stroke: A Systematic review and meta-analysis

## TL;DR

This study reviews and analyzes the use of IVIM imaging in diagnosing acute ischemic stroke, comparing its parameters with traditional methods.

## Contribution

The study provides a systematic review and meta-analysis of IVIM parameters in acute ischemic stroke, offering insights into their quantitative estimation.

## Key findings

- IVIM parameters D and f showed significant standardized mean differences between lesion and normal regions.
- D* showed non-significant effects but could be improved with technical upgrades.
- fD* demonstrated a significant standardized mean difference, indicating potential diagnostic utility.

## Abstract

Intravoxel incoherent motion (IVIM) is a potential diagnostic technique for acute ischemic stroke as it simultaneously quantifies the molecular diffusion and the minute capillary network microcirculation; however, the lack of comprehensive evidence of its utility in acute ischemic stroke necessitates a review to enable better quantitative estimation and understanding of IVIM parameters and their relation with parameters of conventional diffusion and perfusion techniques.

An extensive search strategy yielded 2340 studies in six databases. After a two-step screening process, data from 10 studies were extracted and included in the meta-analysis. Heterogeneity, publication bias, and forest plot analysis were performed for each IVIM parameter: D, D*, f, and fD*.

The mean values for D ranged from 0.28 to 0.58 × 10− 3 mm2/s and from 0.56 to 0.93 × 10− 3 mm2/s in the lesion and contralateral normal region, respectively, with the standardised mean difference of 3.24 SD units and positive correlation with ADC. f-values were between 2.5 and 4.9% ipsilaterally and 4.3 to 7.9% contralaterally, with minimal heterogeneity and a statistically significant standardised mean difference of 2.65 SD units. D* showed a non-significant effect. fD* showed a significant standardised mean difference of 1.48 SD units.

Quantitative differentiation between the core and normal regions was significantly seen in D, f, and fD* parametric maps. Although D* varied across studies, technical upgrading could improve its utility. Since IVIM parameters correlate well with the existing diffusion and perfusion parameters, its utility offers a robust, multifaceted approach to understanding acute ischemic stroke.

Not applicable.

The online version contains supplementary material available at 10.1186/s12880-025-01997-3.