{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T21:55:05Z","timestamp":1791237305354,"version":"4.1.0"},"reference-count":42,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"10","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Stroke"],"published-print":{"date-parts":[[1999,10]]},"abstract":"<jats:p>\n            <jats:italic>Background and Purpose<\/jats:italic>\n            \u2014Combined echoplanar MRI diffusion-weighted imaging (DWI), perfusion imaging (PI), and magnetic resonance angiography (MRA) can be used to visualize acute brain ischemia and predict lesion evolution and functional outcome. The appearance of a larger lesion by PI than by DWI quantitatively defines a mismatch of potential clinical importance. Qualitative lesion variations exist in the topographic concordance of this mismatch. We examined both the topographic heterogeneity and relative frequency of mismatched patterns in acute stroke using these MRI techniques.\n          <\/jats:p>\n          <jats:p>\n            <jats:italic>Methods<\/jats:italic>\n            \u2014Acute DWI, PI, and MRA studies of 34 prospectively recruited patients with supratentorial ischemic lesions scanned within 24 hours of stroke onset (range 2.5 to 23.3 hours, 12 patients &lt;6 hours) were analyzed.\n          <\/jats:p>\n          <jats:p>\n            <jats:italic>Results<\/jats:italic>\n            \u2014Ischemic lesions were predominantly in the middle cerebral artery (MCA) territory (94%), with DWI lesions most commonly affecting the insular region. Mismatched patterns with PI lesion larger than DWI lesion occurred in 21 patients (62% overall), in all 4 patients imaged within 3 hours, and in 44% of patients imaged after 18 hours. A patient with a large PI but no DWI lesion and severe clinical deficit at 2.5 hours after stroke onset recovered completely. Regional variations in DWI and PI lesion loci were found, inferring site of proximal MCA occlusion, embolic pathogenesis, and regional arterial reperfusion.\n          <\/jats:p>\n          <jats:p>\n            <jats:italic>Conclusions<\/jats:italic>\n            \u2014Analysis of the topographic concordance of PI and DWI lesions in acute stroke reveals regional PI lesions without concomitant DWI lesions, which do not necessarily progress to infarction but may suggest stroke pathogenesis and site of current arterial occlusion. Location of DWI lesions may suggest an earlier site of arterial occlusion and regions of maximal perfusion deficit.\n          <\/jats:p>","DOI":"10.1161\/01.str.30.10.2043","type":"journal-article","created":{"date-parts":[[2011,6,17]],"date-time":"2011-06-17T20:08:03Z","timestamp":1308341283000},"page":"2043-2052","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":204,"title":["Pathophysiological Topography of Acute Ischemia by Combined Diffusion-Weighted and Perfusion MRI"],"prefix":"10.1161","volume":"30","author":[{"given":"D. G.","family":"Darby","sequence":"first","affiliation":[{"name":"From the Departments of Neurology (D.G.D., P.A.B., R.P.G., M.P., S.M.D.) and Radiology (P.M.D, Q.Y., T.L., B.M.T.), The Royal Melbourne Hospital, University of Melbourne, Australia."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P. A.","family":"Barber","sequence":"additional","affiliation":[{"name":"From the Departments of Neurology (D.G.D., P.A.B., R.P.G., M.P., S.M.D.) and Radiology (P.M.D, Q.Y., T.L., B.M.T.), The Royal Melbourne Hospital, University of Melbourne, Australia."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R. P.","family":"Gerraty","sequence":"additional","affiliation":[{"name":"From the Departments of Neurology (D.G.D., P.A.B., R.P.G., M.P., S.M.D.) and Radiology (P.M.D, Q.Y., T.L., B.M.T.), The Royal Melbourne Hospital, University of Melbourne, Australia."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P. M.","family":"Desmond","sequence":"additional","affiliation":[{"name":"From the Departments of Neurology (D.G.D., P.A.B., R.P.G., M.P., S.M.D.) and Radiology (P.M.D, Q.Y., T.L., B.M.T.), The Royal Melbourne Hospital, University of Melbourne, Australia."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Q.","family":"Yang","sequence":"additional","affiliation":[{"name":"From the Departments of Neurology (D.G.D., P.A.B., R.P.G., M.P., S.M.D.) and Radiology (P.M.D, Q.Y., T.L., B.M.T.), The Royal Melbourne Hospital, University of Melbourne, Australia."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.","family":"Parsons","sequence":"additional","affiliation":[{"name":"From the Departments of Neurology (D.G.D., P.A.B., R.P.G., M.P., S.M.D.) and Radiology (P.M.D, Q.Y., T.L., B.M.T.), The Royal Melbourne Hospital, University of Melbourne, Australia."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"T.","family":"Li","sequence":"additional","affiliation":[{"name":"From the Departments of Neurology (D.G.D., P.A.B., R.P.G., M.P., S.M.D.) and Radiology (P.M.D, Q.Y., T.L., B.M.T.), The Royal Melbourne Hospital, University of Melbourne, Australia."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"B. M.","family":"Tress","sequence":"additional","affiliation":[{"name":"From the Departments of Neurology (D.G.D., P.A.B., R.P.G., M.P., S.M.D.) and Radiology (P.M.D, Q.Y., T.L., B.M.T.), The Royal Melbourne Hospital, University of Melbourne, Australia."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S. M.","family":"Davis","sequence":"additional","affiliation":[{"name":"From the Departments of Neurology (D.G.D., P.A.B., R.P.G., M.P., S.M.D.) and Radiology (P.M.D, Q.Y., T.L., B.M.T.), The Royal Melbourne Hospital, University of Melbourne, Australia."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_2_1_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199512143332401"},{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1995.03530130023023"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(98)08020-9"},{"key":"e_1_3_2_4_2","first-page":"423","volume":"11","year":"1990","unstructured":"Moseley ME, Kucharczyk J, Mintorovitch J, Cohen Y, Kurhanewicz J, Derugin N, Asgari H, Norman D. Diffusion-weighted MR imaging of acute stroke: correlation with T2-weighted and magnetic susceptibility-enhanced MR imaging in cats. AJNR Am J Neuroradiol. 1990;11:423\u2013429.","journal-title":"AJNR Am J Neuroradiol"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1002\/mrm.1910140218"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1002\/mrm.1910180106"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.51.2.418"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.52.5.1085"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1161\/str.12.6.6272455"},{"key":"e_1_3_2_10_2","unstructured":"Warach S Wielopolski P Edelman R. Identification and characterization of the ischemic penumbra of acute human stroke using echoplanar diffusion and perfusion imaging. In: Proceedings of the 12th Annual Scientific Meeting of the Society of Magnetic Resonance Medicine; 1993; Berkeley Calif. Abstract p 263."},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.52.9.1792"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.52.6.1125"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1002\/ana.410410506"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1148\/radiology.199.2.8668784"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.52.9.1750"},{"key":"e_1_3_2_16_2","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.52.9.1733"},{"key":"e_1_3_2_17_2","doi-asserted-by":"publisher","DOI":"10.1161\/str.29.12.2522"},{"key":"e_1_3_2_18_2","doi-asserted-by":"publisher","DOI":"10.1063\/1.1695690"},{"key":"e_1_3_2_19_2","doi-asserted-by":"publisher","DOI":"10.1161\/str.28.3.483"},{"key":"e_1_3_2_20_2","doi-asserted-by":"publisher","DOI":"10.1002\/mrm.1910310209"},{"key":"e_1_3_2_21_2","doi-asserted-by":"crossref","unstructured":"Lassen NA Henriksen O Sejrsen P. Indicator methods for measurement of organ and tissue blood flow. In: Shepherd JT Abboud FM eds. Handbook of Physiology. Bethesda Md: American Physiological Society; 1983.","DOI":"10.1002\/cphy.cp020302"},{"key":"e_1_3_2_22_2","first-page":"1067","volume":"19","year":"1998","unstructured":"Hennerici M, Daffertshofer M, Jakobs L. Failure to identify cerebral infarct mechanisms from topography of vascular lesions. AJNR Am J Neuroradiol. 1998;19:1067\u20131074.","journal-title":"AJNR Am J Neuroradiol"},{"key":"e_1_3_2_23_2","doi-asserted-by":"publisher","DOI":"10.1161\/str.25.11.7974542"},{"key":"e_1_3_2_24_2","doi-asserted-by":"publisher","DOI":"10.1161\/str.24.12.8248975"},{"key":"e_1_3_2_25_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199607183350301"},{"key":"e_1_3_2_26_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(95)92049-8"},{"key":"e_1_3_2_27_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1996.03540120039031"},{"key":"e_1_3_2_28_2","doi-asserted-by":"publisher","DOI":"10.1002\/ana.410400213"},{"key":"e_1_3_2_29_2","doi-asserted-by":"publisher","DOI":"10.1161\/str.27.4.599"},{"key":"e_1_3_2_30_2","doi-asserted-by":"publisher","DOI":"10.1002\/ana.410410502"},{"key":"e_1_3_2_31_2","doi-asserted-by":"publisher","DOI":"10.1097\/00004647-199603000-00003"},{"key":"e_1_3_2_32_2","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.52.9.1784"},{"key":"e_1_3_2_33_2","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.50.4.864"},{"key":"e_1_3_2_34_2","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.50.4.842"},{"key":"e_1_3_2_35_2","unstructured":"Mohr JP Gautier JC Hier DB. Middle Cerebral Artery Disease. New York NY: Churchill Livingstone Inc; 1992."},{"key":"e_1_3_2_36_2","doi-asserted-by":"publisher","DOI":"10.1148\/radiology.176.3.2389039"},{"key":"e_1_3_2_37_2","doi-asserted-by":"publisher","DOI":"10.1161\/str.9.6.741488"},{"key":"e_1_3_2_38_2","first-page":"51","volume":"114","year":"1991","unstructured":"Donnan GA, Bladin PF, Berkovic SF, Longley WA, Saling MM. The stroke syndrome of striatocapsular infarction. Brain. 1991;114:51\u201371.","journal-title":"Brain"},{"key":"e_1_3_2_39_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(66)92199-4"},{"key":"e_1_3_2_40_2","doi-asserted-by":"publisher","DOI":"10.1002\/ana.410360404"},{"key":"e_1_3_2_41_2","doi-asserted-by":"publisher","DOI":"10.1038\/jcbfm.1986.108"},{"key":"e_1_3_2_42_2","doi-asserted-by":"publisher","DOI":"10.1002\/ana.410390307"}],"container-title":["Stroke"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/01.STR.30.10.2043","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,12]],"date-time":"2024-05-12T22:29:17Z","timestamp":1715552957000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/01.STR.30.10.2043"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[1999,10]]},"references-count":42,"journal-issue":{"issue":"10","published-print":{"date-parts":[[1999,10]]}},"alternative-id":["10.1161\/01.STR.30.10.2043"],"URL":"https:\/\/doi.org\/10.1161\/01.str.30.10.2043","relation":{},"ISSN":["0039-2499","1524-4628"],"issn-type":[{"value":"0039-2499","type":"print"},{"value":"1524-4628","type":"electronic"}],"subject":[],"published":{"date-parts":[[1999,10]]},"assertion":[{"value":"1999-05-21","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"1999-07-16","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"1999-10-01","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}