Diffusion‐Weighted Imaging Volume as the Best Predictor of the Diffusion–Perfusion Mismatch in Acute Stroke Patients within 8 Hours of Onset. Issue 2 (4th March 2014)

• Record Type: Journal Article
• Authors: Aoki, Junya; Tateishi, Yohei; Cummings, Christopher L.; Cheng‐Ching, Esteban; Ruggieri, Paul; Hussain, Muhammad Shazam; Uchino, Ken
• Is Part Of: Journal of neuroimaging. Volume 25:Issue 2(2015)
• Page Start: 217
• Page End: 225
• Publication Date: 2014-03-04
• Subjects: Acute ischemic stroke -- neuroimaging -- DWI/PWI mismatch; Diagnostic imaging -- Periodicals; Nervous system -- Diseases -- Diagnosis -- Periodicals; Imagerie pour le diagnostic -- Périodiques; Système nerveux -- Maladies -- Diagnostic -- Périodiques; Imagerie médicale; Neuroimagerie; Neurologie; Système nerveux; Périodique électronique (Descripteur de forme); Ressource Internet (Descripteur de forme); 616.804754
• DOI: 10.1111/jon.12107
• Languages: English
• ISSNs: 1051-2284

Abstract

ABSTRACT: BACKGROUND: Diagnostic accuracies of standard NCCT, CTA, CTA‐SI, FLAIR, and DWI to detect the diffusion–perfusion mismatch (DPM) were compared. METHODS: Stroke patients considered for endovascular therapy within 8 hours of onset were enrolled. DPM was defined as at least 160% mismatch between DWI and PWI volume. RESULTS: DPM was seen in 35 (71%) of 49 patients. ASPECTS on NCCT, CTA‐SI, and DWI was 9 (8‐9), 8 (6‐9), and 7 (5‐9) in mismatch group, and 6 (4‐9), 6 (2‐7), 5 (2‐6) in nonmismatch group, respectively ( P = .027, .006, and .001). Ischemic volume on CTA‐SI and DWI was 4.6 (.2‐13.0) cm 3 and 21.5 (9.7‐44.0) cm 3 in mismatch group, and 61.5 (6.6‐101.1) cm 3 and 94.9 (45.7‐139.8) cm 3 in nonmismatch group ( P = .003 and <.001). Significant collateralization on CTA‐SI and FLAIR was seen in 80% and 88% in mismatch group, and 42% and 58% in nonmismatch group ( P = .026 and .039). Odds ratios (95% CI) of DWI volume of ≤70 cm 3 to predict the mismatch was 30.17 (2.06‐442.41) after adjusting for ASPECTSs on NCCT, CTA‐SI, and DWI, 44.90 (2.75‐732.73) for ischemic volume on CTA‐SI, and 42.80 (3.05‐601.41) for significant collateralization on CTA‐SI and FLAIR ( P = .013, .008, and .005). CONCLUSIONS: DWI volume was the best predictor of DPM.