BACKGROUND AND PURPOSE: We sought to study the role of MRI-derived cerebral blood flow (CBF) measurements for the prediction of lesion development in acute stroke patients. METHODS: Thirty-two patients were treated with tissue plasminogen activator. Diffusion-weighted (DWI) and perfusion-weighted MRI, T2-weighted imaging, and MR angiography were performed before treatment (2.8+/-0.9 hours after symptom onset) and on follow-up (days 1 and 7). CBF thresholds (12 and 22 mL/100 g per minute) were applied to bolus tracking MRI maps to determine predictive cutoff levels. RESULTS: In 21 patients (group A), the terminal lesion volume (T2-weighted imaging) was larger than the initial DWI lesion volume (89+/-93 versus 21+/-38 mL). In 11 patients (group B), the terminal lesion volume was smaller than the initial DWI lesion volume (7+/-27 versus 15+/-29 mL). The initial DWI lesion volume did not differ between both groups. The presence of a tissue volume > or =50 mL with a CBF value < or =12 mL/100 g per minute was predictive for lesion enlargement to day 7 in T2-weighted imaging (positive predictive value, 0.80). CONCLUSIONS: The presence of a tissue volume > or =50 mL with a CBF value < or =12 mL/100 g per minute predicts further lesion growth in hyperacute stroke patients. MRI-derived CBF values, with all their present limitations, are valuable in early estimation of prognosis of stroke patients.
BACKGROUND AND PURPOSE: We sought to study the role of MRI-derived cerebral blood flow (CBF) measurements for the prediction of lesion development in acute strokepatients. METHODS: Thirty-two patients were treated with tissue plasminogen activator. Diffusion-weighted (DWI) and perfusion-weighted MRI, T2-weighted imaging, and MR angiography were performed before treatment (2.8+/-0.9 hours after symptom onset) and on follow-up (days 1 and 7). CBF thresholds (12 and 22 mL/100 g per minute) were applied to bolus tracking MRI maps to determine predictive cutoff levels. RESULTS: In 21 patients (group A), the terminal lesion volume (T2-weighted imaging) was larger than the initial DWI lesion volume (89+/-93 versus 21+/-38 mL). In 11 patients (group B), the terminal lesion volume was smaller than the initial DWI lesion volume (7+/-27 versus 15+/-29 mL). The initial DWI lesion volume did not differ between both groups. The presence of a tissue volume > or =50 mL with a CBF value < or =12 mL/100 g per minute was predictive for lesion enlargement to day 7 in T2-weighted imaging (positive predictive value, 0.80). CONCLUSIONS: The presence of a tissue volume > or =50 mL with a CBF value < or =12 mL/100 g per minute predicts further lesion growth in hyperacute strokepatients. MRI-derived CBF values, with all their present limitations, are valuable in early estimation of prognosis of strokepatients.
Authors: P A Barber; M D Hill; M Eliasziw; A M Demchuk; J H W Pexman; M E Hudon; A Tomanek; R Frayne; A M Buchan Journal: J Neurol Neurosurg Psychiatry Date: 2005-11 Impact factor: 10.154
Authors: K Mui; A J Yoo; L Verduzco; W A Copen; J A Hirsch; R G González; P W Schaefer Journal: AJNR Am J Neuroradiol Date: 2011-04-07 Impact factor: 3.825
Authors: Feng Chen; Yasuhiro Suzuki; Nobuo Nagai; Ronald Peeters; Xihe Sun; Walter Coudyzer; Guy Marchal; Yicheng Ni Journal: MAGMA Date: 2004-10-26 Impact factor: 2.310
Authors: Sanaz Sedaghat; Meike W Vernooij; Elizabeth Loehrer; Francesco U S Mattace-Raso; Albert Hofman; Aad van der Lugt; Oscar H Franco; Abbas Dehghan; M Arfan Ikram Journal: J Am Soc Nephrol Date: 2015-08-06 Impact factor: 10.121