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Titolo:
Diffusion-perfusion MRI characterization of post-recanalization hyperperfusion in humans
Autore:
Kidwell, CS; Saver, JL; Mattiello, J; Starkman, S; Vinuela, F; Duckwiler, G; Gobin, YP; Jahan, R; Vespa, P; Villablanca, JP; Liebeskind, DS; Woods, RP; Alger, JR;
Indirizzi:
Univ Calif Los Angeles, Stroke Ctr, Med Ctr, Los Angeles, CA 90095 USA Univ Calif Los Angeles Los Angeles CA USA 90095 Los Angeles, CA 90095 USA Univ Calif Los Angeles, Med Ctr, Dept Neurol, Los Angeles, CA 90095 USA Univ Calif Los Angeles Los Angeles CA USA 90095 Los Angeles, CA 90095 USA Univ Calif Los Angeles, Med Ctr, Dept Radiol Sci, Los Angeles, CA 90095 USA Univ Calif Los Angeles Los Angeles CA USA 90095 Los Angeles, CA 90095 USA Univ Calif Los Angeles, Med Ctr, Dept Emergency Med, Los Angeles, CA 90095USA Univ Calif Los Angeles Los Angeles CA USA 90095 Los Angeles, CA 90095USA Univ Calif Los Angeles, Med Ctr, Dept Neurosurg, Los Angeles, CA 90095 USAUniv Calif Los Angeles Los Angeles CA USA 90095 Los Angeles, CA 90095 USA Univ Penn, Dept Neurol, Philadelphia, PA 19104 USA Univ Penn PhiladelphiaPA USA 19104 pt Neurol, Philadelphia, PA 19104 USA Univ Penn, Comprehens Stroke Ctr, Philadelphia, PA 19104 USA Univ Penn Philadelphia PA USA 19104 troke Ctr, Philadelphia, PA 19104 USA
Titolo Testata:
NEUROLOGY
fascicolo: 11, volume: 57, anno: 2001,
pagine: 2015 - 2021
SICI:
0028-3878(200112)57:11<2015:DMCOPH>2.0.ZU;2-X
Fonte:
ISI
Lingua:
ENG
Soggetto:
POSITRON-EMISSION-TOMOGRAPHY; HIGH-RESOLUTION MEASUREMENT; CEREBRAL-ARTERY OCCLUSION; TRACER BOLUS PASSAGES; ISCHEMIC STROKE; POSTISCHEMIC HYPERPERFUSION; SPONTANEOUS REPERFUSION; INFARCTION; TISSUE;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
25
Recensione:
Indirizzi per estratti:
Indirizzo: Kidwell, CS Univ Calif Los Angeles, Stroke Ctr, Med Ctr, 710 Westwood Plaza, Los Angeles, CA 90095 USA Univ Calif Los Angeles 710 Westwood Plaza Los Angeles CA USA 90095
Citazione:
C.S. Kidwell et al., "Diffusion-perfusion MRI characterization of post-recanalization hyperperfusion in humans", NEUROLOGY, 57(11), 2001, pp. 2015-2021

Abstract

Background: Animal and human studies have demonstrated that postischemic hyperperfusion may occur both early and late timepoints following acute cerebral ischemia. Objective: To use diffusion-perfusion MRI to characterize hyperperfusion in humans following intra-arterial thrombolysis. Methods: MRI were performed before treatment, several hours following vessel recanalization, and at day 7 in patients successfully recanalized with intra-arterial thrombolytics. Results: Hyperperfusion was visualized in 5 of 12 patients within several hours after recanalization (mean volume, 18 mL; range, 7 to 40 mL), and in 6 of 11 patients at day 7 (mean volume, 28 mL; range, 4 to 45mL). Within the core region of hyperperfusion, mean cerebral blood flow was 2.1 times greater than in the contralateral homologous region at the early time point, and 3.1 times greater at day 7. Seventy-nine percent of voxels with hyperperfusion at day 7 demonstrated infarction at day 7, whereas only 36% of voxels (within the initial hypoperfusion region) not showing hyperperfusion at day 7 demonstrated infarction at day 7. Mean pretreatment apparent diffusion coefficient (ADC) and perfusion values were more impaired in voxels that subsequently developed hyperperfusion compared with other at-risk voxels (all p values < 0.0001). There were no significant differences in the degree of clinical improvement in patients with regions of hyperperfusion versus those without, although sample size limited power to detect group differences. Conclusions: Postischemic hyperperfusion, visualized with perfusion MRI in humans following recanalization by intra-arterial thrombolytic therapy, occurred in about 40% of patients within hours and in about 50% of patients at day 7. Hyperperfusion developed mainly in regions that went on to infarction. Compared with other abnormal regions, tissues that developed postischemic hyperperfusion had greater bioenergetic compromise in pretreatment apparent diffusion coefficient values and greater impairment inpretreatment blood flow measures.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 18/01/20 alle ore 13:01:44