{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,18]],"date-time":"2026-04-18T03:02:25Z","timestamp":1776481345268,"version":"3.51.2"},"reference-count":9,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2018,11,6]],"date-time":"2018-11-06T00:00:00Z","timestamp":1541462400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Neuroimaging"],"published-print":{"date-parts":[[2019,3]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>BACKGROUND AND PURPOSE<\/jats:title><jats:p>Impaired distal perfusion predicts neurological deterioration in large artery atherosclerosis. We aim to determine the optimal threshold of <jats:italic>T<\/jats:italic>max delay on perfusion imaging that is associated with neurological deterioration in patients with symptomatic proximal anterior circulation large artery stenosis.<\/jats:p><\/jats:sec><jats:sec><jats:title>METHODS<\/jats:title><jats:p>Data were abstracted from a prospective ischemic stroke database of consecutively enrolled patients with symptomatic proximal intracranial stenosis (internal carotid artery or M1 segment of the middle cerebral artery) who underwent magnetic resonance perfusion imaging within 24 hours of symptom onset during a 15\u2010month period. Tissue volumes of perfusion delay <jats:italic>T<\/jats:italic>max 0\u20104 seconds, <jats:italic>T<\/jats:italic>max\u00a0&gt;\u00a04 seconds, <jats:italic>T<\/jats:italic>max\u00a0&gt;\u00a06 seconds, and <jats:italic>T<\/jats:italic>max\u00a0&gt;\u00a08 seconds were calculated using an automated approach. A target mismatch (penumbra\u2014core) was defined as \u226515mL of brain tissue using each of the <jats:italic>T<\/jats:italic>max threshold categories. The outcome was neurological deterioration at 30 days defined as new or worsening neurological deficits that are not attributed to a nonvascular etiology.<\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS<\/jats:title><jats:p>Among 52 patients with symptomatic intracranial stenosis, 26 patients met inclusion criteria. Neurological deterioration was associated with target mismatch profile defined according to <jats:italic>T<\/jats:italic>max\u00a0&gt;\u00a06 seconds (66.7% [6\/9] vs. 5.9% [1\/17], <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a0.01) and <jats:italic>T<\/jats:italic>max\u00a0&gt;8 seconds (57.1% [4\/7] vs. 15.8% [3\/19], <jats:italic>P<\/jats:italic>\u00a0=\u00a0.05] but not according to <jats:italic>T<\/jats:italic>max\u00a0&gt;\u00a04 seconds (27.3% [6\/17] vs. 11.1% [1\/9], <jats:italic>P<\/jats:italic>\u00a0=\u00a0.35].<\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSIONS<\/jats:title><jats:p>A target mismatch profile using <jats:italic>T<\/jats:italic>max\u00a0&gt;\u00a06 seconds may define tissue at risk in patients with acute symptomatic proximal anterior circulation intracranial stenosis. More studies are needed to confirm our findings.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jon.12577","type":"journal-article","created":{"date-parts":[[2018,11,6]],"date-time":"2018-11-06T12:09:00Z","timestamp":1541506140000},"page":"203-205","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":24,"title":["What Threshold Defines Penumbral Brain Tissue in Patients with Symptomatic Anterior Circulation Intracranial Stenosis: An Exploratory Analysis"],"prefix":"10.1111","volume":"29","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0031-1004","authenticated-orcid":false,"given":"Shadi","family":"Yaghi","sequence":"first","affiliation":[{"name":"\u00a0Department of Neurology Warren Alpert Medical School of Brown University  Providence RI\u00a0"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pooja","family":"Khatri","sequence":"additional","affiliation":[{"name":"Department of Neurology University of Cincinnati  Cincinnati OH"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shyam","family":"Prabhakaran","sequence":"additional","affiliation":[{"name":"Department of Neurology Northwestern University  Chicago IL"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sharon D.","family":"Yeatts","sequence":"additional","affiliation":[{"name":"Department of Public Health Sciences Medical University of South Carolina  Charleston SC"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shawna","family":"Cutting","sequence":"additional","affiliation":[{"name":"\u00a0Department of Neurology Warren Alpert Medical School of Brown University  Providence RI\u00a0"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mahesh","family":"Jayaraman","sequence":"additional","affiliation":[{"name":"\u00a0Department of Neurology Warren Alpert Medical School of Brown University  Providence RI\u00a0"},{"name":"Department of Diagnostic Imaging Warren Alpert Medical School of Brown University  Providence RI"},{"name":"Department of Neurosurgery Warren Alpert Medical School of Brown University  Providence RI"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrew D.","family":"Chang","sequence":"additional","affiliation":[{"name":"\u00a0Department of Neurology Warren Alpert Medical School of Brown University  Providence RI\u00a0"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniel","family":"Sacchetti","sequence":"additional","affiliation":[{"name":"\u00a0Department of Neurology Warren Alpert Medical School of Brown University  Providence RI\u00a0"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David S.","family":"Liebeskind","sequence":"additional","affiliation":[{"name":"Department of Neurology University of California at Los Angeles  Los Angeles CA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Karen L.","family":"Furie","sequence":"additional","affiliation":[{"name":"\u00a0Department of Neurology Warren Alpert Medical School of Brown University  Providence RI\u00a0"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2018,11,6]]},"reference":[{"key":"e_1_2_5_2_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaneurol.2015.4906"},{"key":"e_1_2_5_3_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCRESAHA.116.308441"},{"key":"e_1_2_5_4_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaneurol.2015.3772"},{"key":"e_1_2_5_5_1","doi-asserted-by":"publisher","DOI":"10.3174\/ajnr.A3668"},{"key":"e_1_2_5_6_1","doi-asserted-by":"publisher","DOI":"10.1177\/1747493018764075"},{"key":"e_1_2_5_7_1","first-page":"643","article-title":"A standardized method for measuring intracranial arterial stenosis","volume":"21","author":"Samuels OB","year":"2000","journal-title":"AJNR Am J 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