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The benefit of thrombolytic therapy was assessed in 54 patients with a mismatch between infarct core as seen on DWI and penumbra as seen on SWI. Favorable outcomes were significantly higher in patients with DWI-SWI mismatch than in those without it. The accuracy of the DWI-SWI mismatch for predicting good outcome was higher than that for the more traditional DWI-perfusion mismatch.