Characterizing the diffusion/perfusion mismatch in experimental focal cerebral ischemia

Diffusion-weighted imaging (DWI) and perfusion-weighted imaging (PWI) can rapidly detect lesions in acute ischemic stroke patients. The PWI volume is typically substantially larger than the DWI volume shortly after onset, that is, a diffusion/perfusion mismatch. The aims of this study were to follow the evolution of the diffusion/perfusion mismatch in permanent and 60-minute temporary focal experimental ischemia models in Sprague-Dawley rats using the intralu-minal middle cerebral artery occlusion (MCAO) method. DWI and arterial spin-labeled PWI were performed at 30, 60, 90, 120, and 180 minutes after occlusion and lesion volumes (mm3) calculated At 24 hours after MCAO, and infarct volume was determined using triphenyltetrazolium chloride staining. In the permanent MCAO group, the lesion volume on the ADC maps was significantly smaller than that on the cerebral blood flow maps through the first 60 minutes after MCAO; but not after 90 minutes of occlusion. With 60 minutes of transient ischemia, the diffusion/perfusion mismatch was similar, but after reperfusion, the lesion volumes on ADC and cerebral blood flow maps became much smaller. There was a significant difference in 24-hour infarct volumes between the permanent and temporary occlusion groups. Ann Neurol 2004;55:207–212 Diffusion-weighted imaging (DWI) is widely used to investigate hyperacute cerebral ischemia both in exper-imental stroke models and in patients with ischemi