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Advances in magnetic resonance imaging for the evaluation of cerebral watershed infarction
OUYANG Feng  LUO Lan  ZHOU Fuqing  ZENG Xianjun 

DOI:10.12015/issn.1674-8034.2026.02.024.


[Abstract] Cerebral watershed infarction (WI) is a key subset of ischemic stroke and the predominant infarct pattern in patients with occlusive disease of the major head-and-neck arteries. It is characterized by “a narrow perfusion-infarction threshold, covert exhaustion of compensatory reserve, and a short therapeutic time window”. Even under “optimal” medical therapy, these patients remain at high risk of recurrence. With advances in imaging, magnetic resonance imaging (MRI) has evolved from purely structural assessment to multidimensional quantitative evaluation that incorporates hemodynamic and functional information, providing objective evidence and a powerful tool for early identification of WI. Nevertheless, the selection of quantitative techniques, harmonization of quantitative criteria, and precise linkage to pathophysiology and clinical outcome are still critical challenges that must be overcome in the MRI-based evaluation of WI. To this end, this review summarizes current clinical knowledge on WI and the latest MRI applications for hemodynamic evaluation, analyzes the limitations of existing research, and proposes future research directions to inform subsequent studies.
[Keywords] ischemic stroke；cerebral watershed infarction；hemodynamics impairment；magnetic resonance imaging；evaluation

OUYANG Feng   LUO Lan   ZHOU Fuqing   ZENG Xianjun*  

Department of Radiology, the First Affiliated Hospital of Nanchang University, Nanchang 330006, China

Corresponding author: ZENG X J, E-mail: xianjun-zeng@126.com

Conflicts of interest   None.

Received  2025-11-24
Accepted  2026-01-30
DOI: 10.12015/issn.1674-8034.2026.02.024
DOI:10.12015/issn.1674-8034.2026.02.024.

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