title: Usefulness of MRA-DWI mismatch in neuroendovascular therapy for acute cerebral infarction.
abstract: BACKGROUND
  This study evaluated the usefulness of MR angiography (MRA)-diffusion-weighted imaging (DWI) mismatch in neuroendovascular therapy over 3 h after onset of acute cerebral infarction.
  
  
  METHODS
  The subjects were 14 cases (age, 73 ± 8.4 years) who had an anterior circulation deficit on DWI/MRA on arrival and underwent neuroendovascular therapy over 3 h after onset. MRA-DWI mismatch (MDM) (+) was defined as 'major artery lesion (+) and diffusion-weighted image-Alberta Stroke Program Early CT Score (DWI-ASPECTS) ≥6'; MDM (-) was defined as 'major artery lesion (+) and DWI-ASPECTS <6'.
  
  
  RESULTS
  Reperfusion was achieved in nine of 14 patients (64%) undergoing neuroendovascular therapy. Within the reperfusion group, in the five MDM (+) patients and the four MDM (-) patients, the outcome was a favorable clinical response in the MDM (+) group. The modified Rankin Scale (mRS) scores after 90 days were 0-2 in 3 (60%) and 3-6 in 2 (40%) of the MDM (+) group patients and 0-2 in 0 (0%) and 3-6 in 4 (100%) of the MDM (-) group patients. In the MDM (+) group, a good outcome was achieved. However, the number of cases was small, so this was not a significant difference. Within the non-reperfusion group, in the three MDM (+) patients and the two MDM (-) patients, the mRS scores after 90 days were 0-2 in 1 (33%) and 3-6 in 2 (67%) of the MDM (+) group patients and 0-2 in 0 (0%) and 3-6 in 2 (100%) of the MDM (-) group patients. In both groups, the outcome was poor.
  
  
  CONCLUSIONS
  With neuroendovascular therapy, a good outcome with reperfusion was achieved in the MDM (+) group compared to the MDM (-) group. This suggests that the presence or absence of MDM may be useful in determining prognosis after reperfusion.
authors.affiliation: Department of Neurology and Cerebrovascular Medicine, Saitama International Medical Center, Saitama Medical University, Saitama, Japan. ideguchi@saitama-med.ac.jp
authors.forename: I
authors.initials: I
authors.lastname: Deguchi
authors.forename: T
authors.initials: T
authors.lastname: Dembo
authors.forename: T
authors.initials: T
authors.lastname: Fukuoka
authors.forename: H
authors.initials: H
authors.lastname: Nagoya
authors.forename: H
authors.initials: H
authors.lastname: Maruyama
authors.forename: Y
authors.initials: Y
authors.lastname: Kato
authors.forename: Y
authors.initials: Y
authors.lastname: Oe
authors.forename: Y
authors.initials: Y
authors.lastname: Horiuchi
authors.forename: H
authors.initials: H
authors.lastname: Takeda
authors.forename: N
authors.initials: N
authors.lastname: Tanahashi
mesh_terms: D000368:Aged; D002544:Cerebral Infarction / Q000175:diagnosis* / Q000601:surgery*; D038524:Diffusion Magnetic Resonance Imaging; D057510:Endovascular Procedures; D005260:Female; D006801:Humans; D018810:Magnetic Resonance Angiography; D008297:Male; D019635:Neurosurgical Procedures; D016896:Treatment Outcome