Perfusion-diffusion mismatch predicts early XXXX in anterior circulation @entity1188 without thrombolysis.

@entity1 @entity64 @entity16 @entity1188 @entity385
UNASSIGNED: Perfusion-diffusion mismatch in magnetic resonance imaging (MRI) represents the non-core hypoperfused area in acute @entity385 . The mismatch has been used to predict clinical response after thrombolysis in acute @entity385 , but its role for predicting early @entity16 (END) in acute @entity385 without thrombolysis has not been clarified yet. In this study, we prospectively recruited 54 @entity1 with acute non-lacunar @entity385 in anterior circulation without thrombolysis. All @entity1 received the first perfusion MRI within 24 hours from @entity64 onset. Target mismatch profile was defined as a perfusion-diffusion mismatch ratio >=  1.2. END was defined as an increase of >=  4 points in the National Institute of Health @entity64 Scale (NIHSS) score within 72 hours. There were 13 (24.1%) @entity1 developing END, which was associated with larger @entity1188 growth (p = 0.002), worse modified Rankin Scale (p = 0.001) and higher mortality rate at 3 months (p = 0.025). Target mismatch profiles measured by Tmax >=  4, 5 and 6 seconds were independent predictors for END after correcting initial NIHSS score. Among the 3 Tmax thresholds, target mismatch measured by Tmax >=  6 seconds had the highest odd's ratio in predicting END (p < 0.01, odd's ratio = 17), with an 80% sensitivity and a 79.5% specificity. In conclusion, perfusion-diffusion mismatch could identify the @entity1 at high risk of early clinical worsening in acute @entity385 without thrombolysis.
