Evidence map›Paper›PMID 24699054›Full record

ArticleStroke2014

Comparison of magnetic resonance imaging mismatch criteria to select patients for endovascular stroke therapy.

Nishant K Mishra, Gregory W Albers, Søren Christensen, Michael Marks, Scott Hamilton, Matus Straka, John T P Liggins, Stephanie Kemp, Michael Mlynash, Roland Bammer and 2 more

Abstract readComparative Study
In one paragraph

Article in Stroke, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

7 citing papers in PubMed.

  1. Review
  2. Article
  3. Effect of MR-guided perfusion imaging mismatch profiles within 6 h on endovascular thrombectomy outcomes.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2025
    Article
  4. Article
  5. Article
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  7. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

Nishant K MishraFrom the Department of Neurology, Stanford Stroke Center, Palo Alto, CA (N.K.M., G.W.A., S.C., S.H., M.S., J.T.P.L., S.K., M. Mlynash, R.B., M.G.L.); and Department of Radiology, Stanford University Medical Center, Palo Alto, CA (M. Marks, R.B.).
Gregory W Albers
Søren Christensen
Michael Marks
Scott Hamilton
Matus Straka
John T P Liggins
Stephanie Kemp
Michael Mlynash
Roland Bammer
Maarten G Lansberg
Diffusion and Perfusion Imaging Evaluation for Understanding Stroke Evolution 2 Investigators

Funding

CTP to predict Response to recanalization in Ischemic Stroke Project (CRISP)R01NS075209 · NINDS · STANFORD UNIVERSITY · PI LANSBERG, MAARTEN G · 2011 to 2023
$6.0M
NEW MRI TECHNIQUES PRIOR TO T-PA THERAPY AFTER STROKER01NS039325 · NINDS · STANFORD UNIVERSITY · PI ALBERS, GREGORY W · 2000 to 2010
$4.4M
NINDS NIH HHS R01 NS039325NINDS NIH HHS R01 NS03932505NINDS NIH HHS R01 NS075209
6 · The paper itself

Abstract

background and purposeThe Diffusion and Perfusion Imaging Evaluation for Understanding Stroke Evolution 2 (DEFUSE 2) study has shown that clinical response to endovascular reperfusion differs between patients with and without perfusion-diffusion (perfusion-weighted imaging-diffusion-weighted imaging, PWI-DWI) mismatch: patients with mismatch have a favorable clinical response to reperfusion, whereas patients without mismatch do not. This study examined whether alternative mismatch criteria can also differentiate patients according to their response to reperfusion.

methodsPatients from the DEFUSE 2 study were categorized according to vessel occlusion on magnetic resonance angiography (MRA) and DWI lesion volume criteria (MRA-DWI mismatch) and symptom severity and DWI criteria (clinical-DWI mismatch). Favorable clinical response was defined as an improvement of ≥8 points on the National Institutes of Health Stroke Scale (NIHSS) by day 30 or an NIHSS score of ≤1 at day 30. We assessed, for each set of criteria, whether the association between reperfusion and favorable clinical response differed according to mismatch status.

resultsA differential response to reperfusion was observed between patients with and without MRA-DWI mismatch defined as an internal carotid artery or M1 occlusion and a DWI lesion<50 mL. Reperfusion was associated with good functional outcome in patients who met these MRA-DWI mismatch criteria (odds ratio [OR], 8.5; 95% confidence interval [CI], 2.3-31.3), whereas no association was observed in patients who did not meet these criteria (OR, 0.5; 95% CI, 0.08-3.1; P for difference between the odds, 0.01). No differential response to reperfusion was observed with other variations of the MRA-DWI or clinical-DWI mismatch criteria.

conclusionsThe MRA-DWI mismatch is a promising alternative to DEFUSE 2's PWI-DWI mismatch for patient selection in endovascular stroke trials.

Indexed as

Cerebrovascular DisordersAgedAged, 80 and overCarotid Artery DiseasesDiffusion Magnetic Resonance ImagingFemaleHumansInfarction, Middle Cerebral ArteryMagnetic Resonance AngiographyMaleMiddle AgedMultimodal ImagingPerfusion ImagingReperfusionSeverity of Illness IndexStrokereperfusionstroke

Identifiers

PMID24699054
PMCPMC4007191

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.