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Visual perfusion-diffusion mismatch is equivalent to quantitative mismatch.

Marie Luby1, Katherine D Ku, Lawrence L Latour

  • 1Section on Stroke Diagnostics and Therapeutics, 10 Center Drive, MSC 1063, Building 10, Room B1D733, Bethesda, MD 20892-1063, USA. lubym@ninds.nih.gov

Stroke
|February 12, 2011
PubMed
Summary
This summary is machine-generated.

Qualitative diffusion-weighted imaging (DWI) and perfusion-weighted imaging (PWI) MRI mismatch evaluation reliably identifies the same stroke patients for thrombolytic treatment as quantitative measurements.

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Area of Science:

  • Neurology
  • Radiology
  • Medical Imaging

Background:

  • Stroke MRI mismatch, assessed qualitatively using diffusion-weighted imaging (DWI) and perfusion-weighted imaging (PWI), is used clinically.
  • MRI provides crucial evidence of ischemia before thrombolytic therapy.

Purpose of the Study:

  • To assess the reliability of qualitative MRI mismatch evaluation.
  • To compare qualitative and quantitative mismatch measurements in patients receiving thrombolytic treatment.

Main Methods:

  • Seventy patients treated with intravenous recombinant tissue plasminogen activator and pre-treatment MRI were analyzed.
  • Quantitative mismatch was defined as a >50 mL difference between abnormal mean transit time and DWI volumes.
  • Patient characteristics and outcomes were compared between qualitative and quantitative mismatch groups.

Main Results:

  • Qualitative mismatch assessment demonstrated high sensitivity (0.82), specificity (0.80), accuracy (0.81), and positive predictive value (0.88) compared to quantitative methods.
  • No significant differences in patient characteristics or thrombolytic outcomes were observed between the qualitative and quantitative mismatch groups.

Conclusions:

  • Qualitative MRI mismatch evaluation is a reliable method for identifying stroke patients eligible for thrombolytic therapy.
  • Qualitative assessment aligns with quantitative measurements in selecting patients for treatment.