Collateral circulation assessment within the 4.5 h time window in patients with and without DWI/FLAIR MRI mismatch

Journal of the Neurological Sciences
Yves BerthezeneNorbert Nighoghossian

Abstract

The aim of the present study was to assess the association between collateral status and DWI-FLAIR mismatch in patients with acute ischemic stroke within the 4.5 h time-window. We analysed DWI, FLAIR, and PWI data in patients within 4.5 h after symptom onset from the I-KNOW European database. Collateral flow maps were graded by analyzing contrast 'staining' extent over the early, mid and late perfusion phases. ADC values, DWI lesion volume, and normalised perfusion parameters (CBV,Tmax) within DWI lesions were determined. Visibility of parenchymal hyperintensivty on FLAIR was evaluated ("FLAIR positive"), and DWI-FLAIR mismatch was assessed. Spontaneously reperfused regions were defined as voxels with Tmax <6 s within the DWI lesion. Final infarct size was assessed on day-30 FLAIR images. Of the 168 patients included in I-KNOW database, 87 were eligible for this study. DWI-FLAIR mismatch was present in 69 patients. There was no difference between poor and good collaterals status according to age, sex, baseline NIHSS score, time to MRI and DWI lesion volume. Collateral status was significantly better in the FLAIR positive group (p = .001). Patients with poor collaterals had significantly increased Tmax (p = .005). Baseline DWI l...Continue Reading

Citations

Apr 1, 2020·Annals of Neurology·Lauranne ScheldemanUNKNOWN WAKE-UP Investigators
Jun 25, 2020·Scientific Reports·Pulak GoswamiAdrienne N Dula

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