Optimal Definition for PWI/DWI Mismatch in Acute Ischemic Stroke Patients

Overview

Journal J Cereb Blood Flow Metab

Publisher Sage Publications

Specialties Cardiology & Vascular Diseases
Endocrinology
Neurology

Date 2008 Jan 10

PMID 18183031

Citations 58

Authors

Wataru Kakuda

Maarten G Lansberg

Vincent N Thijs

Stephanie M Kemp

Roland Bammer

Lawrence R Wechsler

Michael E Moseley

Michael P Marks

Michael P Parks

Gregory W Albers

Affiliations

Soon will be listed here.

Abstract

Although the perfusion-weighted imaging/diffusion-weighted imaging (PWI/DWI) mismatch model has been proposed to identify acute stroke patients who benefit from reperfusion therapy, the optimal definition of a mismatch is uncertain. We evaluated the odds ratio for a favorable clinical response in mismatch patients with reperfusion compared with no reperfusion for various mismatch ratio thresholds in patients enrolled in the diffusion and perfusion imaging evaluation for understanding stroke evolution (DEFUSE) study. A mismatch ratio of 2.6 provided the highest sensitivity (90%) and specificity (83%) for identifying patients in whom reperfusion was associated with a favorable response. Defining mismatch with a larger PWI/DWI ratio may provide greater power for detecting beneficial effects of reperfusion.

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