Open AccessOptimal Definition for PWI/DWI Mismatch in Acute Ischemic Stroke Patients
Author(s) -
Wataru Kakuda,
Maarten G. Lansberg,
Vincent Thijs,
Stephanie Kemp,
Roland Bammer,
Lawrence R. Wechsler,
Michael E. Moseley,
Michael P Parks,
Gregory W. Albers
Publication year - 2008
Publication title -
journal of cerebral blood flow and metabolism
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.167
H-Index - 193
eISSN - 1559-7016
pISSN - 0271-678X
DOI - 10.1038/sj.jcbfm.9600604
Subject(s) - medicine , diffusion mri , stroke (engine) , acute stroke , odds ratio , diagnostic odds ratio , perfusion scanning , perfusion , magnetic resonance imaging , cardiology , radiology , diagnostic accuracy , mechanical engineering , tissue plasminogen activator , engineering
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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