Skip to main content

Lund University Publications

LUND UNIVERSITY LIBRARIES

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

Wouters, Anke ; Dupont, Patrick ; Ringelstein, Erich B ; Norrving, Bo LU ; Chamorro, Angel ; Grond, Martin ; Laage, Rico ; Schneider, Armin ; Wilms, Guido and Thomalla, Götz , et al. (2015) In Journal of Cerebral Blood Flow and Metabolism 35(10). p.1681-1686
Abstract
The perfusion-/diffusion-weighted imaging (PWI/DWI) mismatch and the diffusion/fluid attenuated inversion recovery (DWI/FLAIR) mismatch are magnetic resonance imaging (MRI) markers of evolving brain ischemia. We examined whether the DWI/FLAIR mismatch was independently associated with the PWI/DWI mismatch. Furthermore, we determined whether the presence of the DWI/FLAIR mismatch in patients with the PWI/DWI mismatch would provide additional information regarding last seen normal time (LTM). We used data from the 'AX200 for ischemic stroke' trial (AXIS 2 study NCT00927836). We studied the association between the presence of the DWI/FLAIR and PWI/DWI mismatch, baseline National Institute of Health Stroke Scale (NIHSS), age, ischemic-core... (More)
The perfusion-/diffusion-weighted imaging (PWI/DWI) mismatch and the diffusion/fluid attenuated inversion recovery (DWI/FLAIR) mismatch are magnetic resonance imaging (MRI) markers of evolving brain ischemia. We examined whether the DWI/FLAIR mismatch was independently associated with the PWI/DWI mismatch. Furthermore, we determined whether the presence of the DWI/FLAIR mismatch in patients with the PWI/DWI mismatch would provide additional information regarding last seen normal time (LTM). We used data from the 'AX200 for ischemic stroke' trial (AXIS 2 study NCT00927836). We studied the association between the presence of the DWI/FLAIR and PWI/DWI mismatch, baseline National Institute of Health Stroke Scale (NIHSS), age, ischemic-core volume, gender, intravenous (IV) tissue plasminogen activator (tPA), and perfusion-mismatch volume in univariate analysis. Significant variables (P<0.05) were added into the final multivariate model. We analyzed 197 patients. Seventy-two (37%) had both the PWI/DWI and the DWI/FLAIR mismatch. Patients with the double mismatch pattern had a shorter LTM than patients with the PWI/DWI mismatch alone (Median difference 90 minutes, P<0.01). Multivariate analysis confirmed the independent association between the two mismatch patterns (odds ratio (OR) 2.6, 95% confidence interval (CI) 1.2 to 5.4). Our study implies that the DWI/FLAIR mismatch and PWI/DWI mismatch are strongly associated, independent from LTM. Furthermore, in the presence of the PWI/DWI mismatch, the DWI/FLAIR pattern indicates a shorter LTM. This could have implications in selecting patients for reperfusion therapy.Journal of Cerebral Blood Flow & Metabolism advance online publication, 3 June 2015; doi:10.1038/jcbfm.2015.108. (Less)
Please use this url to cite or link to this publication:
author
; ; ; ; ; ; ; ; and , et al. (More)
; ; ; ; ; ; ; ; ; ; and (Less)
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Journal of Cerebral Blood Flow and Metabolism
volume
35
issue
10
pages
1681 - 1686
publisher
Nature Publishing Group
external identifiers
  • pmid:26036936
  • wos:000362045300018
  • scopus:84942980829
  • pmid:26036936
ISSN
1559-7016
DOI
10.1038/jcbfm.2015.108
language
English
LU publication?
yes
id
b01b0703-5fa7-4789-8c80-1ba005b1b8fe (old id 7508471)
alternative location
http://www.ncbi.nlm.nih.gov/pubmed/26036936?dopt=Abstract
date added to LUP
2016-04-01 11:09:31
date last changed
2022-02-10 17:11:52
@article{b01b0703-5fa7-4789-8c80-1ba005b1b8fe,
  abstract     = {{The perfusion-/diffusion-weighted imaging (PWI/DWI) mismatch and the diffusion/fluid attenuated inversion recovery (DWI/FLAIR) mismatch are magnetic resonance imaging (MRI) markers of evolving brain ischemia. We examined whether the DWI/FLAIR mismatch was independently associated with the PWI/DWI mismatch. Furthermore, we determined whether the presence of the DWI/FLAIR mismatch in patients with the PWI/DWI mismatch would provide additional information regarding last seen normal time (LTM). We used data from the 'AX200 for ischemic stroke' trial (AXIS 2 study NCT00927836). We studied the association between the presence of the DWI/FLAIR and PWI/DWI mismatch, baseline National Institute of Health Stroke Scale (NIHSS), age, ischemic-core volume, gender, intravenous (IV) tissue plasminogen activator (tPA), and perfusion-mismatch volume in univariate analysis. Significant variables (P&lt;0.05) were added into the final multivariate model. We analyzed 197 patients. Seventy-two (37%) had both the PWI/DWI and the DWI/FLAIR mismatch. Patients with the double mismatch pattern had a shorter LTM than patients with the PWI/DWI mismatch alone (Median difference 90 minutes, P&lt;0.01). Multivariate analysis confirmed the independent association between the two mismatch patterns (odds ratio (OR) 2.6, 95% confidence interval (CI) 1.2 to 5.4). Our study implies that the DWI/FLAIR mismatch and PWI/DWI mismatch are strongly associated, independent from LTM. Furthermore, in the presence of the PWI/DWI mismatch, the DWI/FLAIR pattern indicates a shorter LTM. This could have implications in selecting patients for reperfusion therapy.Journal of Cerebral Blood Flow &amp; Metabolism advance online publication, 3 June 2015; doi:10.1038/jcbfm.2015.108.}},
  author       = {{Wouters, Anke and Dupont, Patrick and Ringelstein, Erich B and Norrving, Bo and Chamorro, Angel and Grond, Martin and Laage, Rico and Schneider, Armin and Wilms, Guido and Thomalla, Götz and Lemmens, Robin and Thijs, Vincent N}},
  issn         = {{1559-7016}},
  language     = {{eng}},
  number       = {{10}},
  pages        = {{1681--1686}},
  publisher    = {{Nature Publishing Group}},
  series       = {{Journal of Cerebral Blood Flow and Metabolism}},
  title        = {{Association between the perfusion/diffusion and diffusion/FLAIR mismatch: data from the AXIS2 trial.}},
  url          = {{http://dx.doi.org/10.1038/jcbfm.2015.108}},
  doi          = {{10.1038/jcbfm.2015.108}},
  volume       = {{35}},
  year         = {{2015}},
}