Raquel da Cruz Bezerra1, William A. Copen2, Elissa McIntosh1, Izzuddin Diwan1, Priya Garg1, Steven Mocking1, Taylor W. Kimberly3, Ethem Murat Arsava1, Ruijun Ji3, Hakan Ay1, Aneesh B. Singhal3, Pamela W. Schaefer2, Ona Wu1
1Radiology, MGH, Athinoula A Martinos Center for Biomedical Imaging, Boston, MA, United States; 2Radiology, Massachusetts General Hospital, Boston, MA, United States; 3Neurology, Massachusetts General Hospital, Boston, MA, United States
We investigated the relationship between proximal arterial occlusion/stenosis on CTA and DWI-PWI mismatch in acute ischemic stroke patients (N=95). The sensitivity of proximal occlusion/stenosis in predicting DWI-PWI mismatch was 84% [95% CI: 72-92%] for MTT, and 85% [73-93%] for Tmax. The specificity of proximal occlusion/stenosis in predicting mismatch was 67% [48-81%] for MTT and 68% [49-82%] for Tmax. One third of patients without occlusion/stenosis had mismatch. Approximately 20% of patients with occlusion/stenosis did not exhibit mismatch. Therefore, a combination of vessel imaging and PWI would be pertinent for selecting patients likely to benefit from extended time-window therapies.