Optimal definition for PWI/DWI mismatch in acute ischemic stroke patients
Kakuda, Wataru × Lansberg, Maarten G Thijs, Vincent Kemp, Stephanie M Bammer, Roland Wechsler, Lawrence R Moseley, Michael E Parks, Michael P Albers, Gregory W #
Lippincott Williams & Wilkins
Journal of Cerebral Blood Flow and Metabolism vol:28 issue:5 pages:887-891
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.Journal of Cerebral Blood Flow & Metabolism advance online publication, 9 January 2008; doi:10.1038/sj.jcbfm.9600604.