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Relative CBV ratio on perfusion-weighted MRI indicates the probability of early recanalization after IV t-PA administration for acute ischemic stroke.
- Source :
-
Journal of neurointerventional surgery [J Neurointerv Surg] 2016 Mar; Vol. 8 (3), pp. 235-9. Date of Electronic Publication: 2015 Jan 12. - Publication Year :
- 2016
-
Abstract
- Background: We hypothesized that the relative cerebral blood volume (rCBV) ratio on perfusion-weighted imaging (PWI) using MRI might serve as a predictor of early recanalization (ER) after intravenous tissue plasminogen activator (IV t-PA) administration for acute ischemic stroke.<br />Methods: Patients with acute middle cerebral artery (MCA) ischemic stroke (IS) were enrolled in the study. They were evaluated by MRI, including PWI and diffusion-weighted imaging, before administration of IV t-PA and underwent digital subtraction angiography (DSA) of the brain within 2 h after t-PA administration. We compared the rCBV ratio on PWI between patients with and without ER on DSA and investigated the proportion of patients with an excellent outcome at 90 days after t-PA administration (modified Rankin Scale score 0-1) among those with and without ER.<br />Results: 85 patients with acute MCA IS were included; 16 patients (18.8%) experienced ER on DSA after IV t-PA administration. Patients with ER more frequently had an excellent outcome at 90 days than those without ER. The rCBV ratio on PWI was higher in the ER group (1.01±0.21, p<0.01) than in the non-ER group (0.82±0.18). After adjusting for the presence of atrial fibrillation and the serum glucose level, the rCBV ratio on PWI (OR 1.07; 95% CI 1.02 to 1.12; p<0.01) was a significant independent indicator of ER.<br />Conclusions: The results of this study suggest that the rCBV ratio on PWI might serve as a useful indicator of ER after IV t-PA administration.<br /> (Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/)
- Subjects :
- Aged
Blood Volume drug effects
Brain Ischemia diagnosis
Brain Ischemia drug therapy
Cerebrovascular Circulation drug effects
Female
Humans
Infusions, Intravenous
Male
Middle Aged
Probability
Reperfusion methods
Retrospective Studies
Stroke diagnosis
Stroke drug therapy
Blood Volume physiology
Brain Ischemia physiopathology
Cerebrovascular Circulation physiology
Magnetic Resonance Angiography methods
Stroke physiopathology
Tissue Plasminogen Activator administration & dosage
Subjects
Details
- Language :
- English
- ISSN :
- 1759-8486
- Volume :
- 8
- Issue :
- 3
- Database :
- MEDLINE
- Journal :
- Journal of neurointerventional surgery
- Publication Type :
- Academic Journal
- Accession number :
- 25583534
- Full Text :
- https://doi.org/10.1136/neurintsurg-2014-011501