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Related Concept Videos

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Association between the perfusion/diffusion and diffusion/FLAIR mismatch: data from the AXIS2 trial.

Anke Wouters1, Patrick Dupont2,3, Erich B Ringelstein4

  • 1Department of Neurosciences and Experimental Neurology, KULeuven, Leuven, Belgium.

Journal of Cerebral Blood Flow and Metabolism : Official Journal of the International Society of Cerebral Blood Flow and Metabolism
|June 4, 2015
PubMed
Summary
This summary is machine-generated.

The diffusion/fluid attenuated inversion recovery (DWI/FLAIR) mismatch and perfusion-/diffusion-weighted imaging (PWI/DWI) mismatch are linked in acute ischemic stroke. The DWI/FLAIR mismatch indicates a shorter time since last normal, aiding reperfusion therapy selection.

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Area of Science:

  • Neuroimaging
  • Stroke Imaging
  • Ischemic Stroke

Background:

  • Perfusion-/diffusion-weighted imaging (PWI/DWI) and diffusion/fluid attenuated inversion recovery (DWI/FLAIR) mismatches are key MRI markers for evolving brain ischemia.
  • These imaging techniques help identify brain tissue at risk during acute ischemic stroke.

Purpose of the Study:

  • To investigate the independent association between DWI/FLAIR mismatch and PWI/DWI mismatch.
  • To determine if DWI/FLAIR mismatch provides additional information on last seen normal (LTM) time in patients with PWI/DWI mismatch.

Main Methods:

  • Analysis of data from the 'AX200 for ischemic stroke' trial (AXIS 2 study).
  • Univariate and multivariate analyses assessed associations between mismatch patterns and clinical/imaging variables.
  • 197 patients with acute ischemic stroke were included.

Main Results:

  • Seventy-two patients (37%) exhibited both PWI/DWI and DWI/FLAIR mismatches.
  • Patients with the double mismatch pattern had a significantly shorter LTM (median difference 90 minutes).
  • Multivariate analysis confirmed an independent association between the two mismatch patterns (OR 2.6).

Conclusions:

  • DWI/FLAIR and PWI/DWI mismatches are strongly and independently associated in acute ischemic stroke.
  • The presence of DWI/FLAIR mismatch, in addition to PWI/DWI mismatch, signifies a shorter LTM.
  • These findings may refine patient selection for reperfusion therapies in stroke management.