A Mismatch Between the Abnormalities in Diffusion- and Susceptibility-Weighted Magnetic Resonance Imaging May Represent an Acute Ischemic Penumbra with Misery Perfusion

Research output: Contribution to journalArticle


Susceptibility-weighted imaging (SWI) has recently attracted attention for its ability to investigate acute stroke pathophysiology. SWI detects an increased ratio of deoxyhemoglobin to oxyhemoglobin in cerebral venous compartments, which can illustrate cerebral misery perfusion with a compensatory increase of oxygen extraction fraction in the hypoperfused brain. In this study we make the first case report of blunt cervical trauma leading to a stroke, demonstrating the disparity between diffusion-weighted imaging (DWI) and SWI changes, or DWI-SWI mismatch, in the acute ischemic brain. The area of mismatch between a smaller DWI cytotoxic edema and a larger SWI misery perfusion in our patient matured into a complete infarction with time. The DWI-SWI mismatch may signify the presence of an ischemic penumbra, and provide information about viability of the brain tissue at risk of potential infarction if without early reperfusion.


  • Masayuki Fujioka
  • Kazuo Okuchi
  • Asami Iwamura
  • Toshiaki Taoka
  • Bo Siesjö
Research areas and keywords

Subject classification (UKÄ) – MANDATORY

  • Neurology


  • Diffusion-weighted imaging, susceptibility-weighted imaging, ischemic-penumbra, misery-perfusion, brain, magnetic resonance imaging
Original languageEnglish
Pages (from-to)1428-1431
JournalJournal of Stroke & Cerebrovascular Diseases
Issue number8
Publication statusPublished - 2013
Publication categoryResearch