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首页> 外文期刊>Journal of Cerebral Blood Flow and Metabolism: Official Journal of the International Society of Cerebral Blood Flow and Metabolism >Association between the perfusion/diffusion and diffusion/FLAIR mismatch: data from the AXIS2 trial
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Association between the perfusion/diffusion and diffusion/FLAIR mismatch: data from the AXIS2 trial

机译：灌注/扩散与扩散/ FLAIR不匹配之间的关联：来自AXIS2试验的数据

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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.
机译：灌注/扩散加权成像（PWI / DWI）失配和扩散/流体衰减反转恢复（DWI / FLAIR）失配是不断发展的脑缺血的磁共振成像（MRI）标记。我们检查了DWI / FLAIR不匹配是否与PWI / DWI不匹配独立相关。此外，我们确定PWI / DWI不匹配的患者中DWI / FLAIR不匹配的存在是否会提供有关上次正常时间（LTM）的其他信息。我们使用了“用于缺血性卒中的AX200”试验的数据（AXIS 2研究NCT00927836）。我们研究了DWI / FLAIR和PWI / DWI不匹配，基线国立卫生研究院卒中量表（NIHSS），年龄，局部缺血核心量，性别，静脉内（IV）组织纤溶酶原激活剂（tPA）和单变量分析中的灌注不匹配量。将显着变量（P <0.05）添加到最终的多元模型中。我们分析了197例患者。七十二（37％）的PWI / DWI和DWI / FLAIR不匹配。双重错配模式的患者的LTM短于单独的PWI / DWI错配的患者（中位数差异90分钟，P <0.01）。多变量分析证实了两种失配模式之间的独立关联（比值比（OR）为2.6，95％置信区间（CI）为1.2至5.4）。我们的研究表明，DWI / FLAIR不匹配和PWI / DWI不匹配紧密相关，独立于LTM。此外，在PWI / DWI不匹配的情况下，DWI / FLAIR模式表示LTM较短。这可能会影响选择再灌注治疗的患者。

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