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弥散加权成像(diffusion-weighted imaging, DWI)可在卒中早期较为敏感地显示缺血灶，为明确诊断急性缺血性卒中提供可靠的影像学证据。然而，部分急性缺血性卒中患者早期DWI呈阴性，导致漏诊和误诊。文章对DWI阴性急性缺血性卒中患者的临床特点、可能原因及影像学改进策略进行了综述。“,”Diffusion-weighted imaging (DWI) can sensitively reveal ischemic lesions in the early stage of stroke, providing reliable imaging evidence for definite diagnosis of acute ischemic stroke. However, some patients with acute ischemic stroke showed negative DWI in the early stage, leading to missed diagnosis and misdiagnosis. This article reviews the clinical characteristics, possible causes and imaging improvement strategies of patients with DWI-negative acute ischemic stroke.