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Titolo:
Perfusion magnetic resonance imaging maps in hyperacute stroke - Relative cerebral blood flow most accurately identifies tissue destined to infarct
Autore:
Parsons, MW; Yang, Q; Barber, PA; Darby, DG; Desmond, PM; Gerraty, RP; Tress, BM; Davis, SM;
Indirizzi:
Royal Melbourne Hosp, Dept Neurol, Parkville, Vic 3050, Australia Royal Melbourne Hosp Parkville Vic Australia 3050 le, Vic 3050, Australia Royal Melbourne Hosp, Dept Radiol, Parkville, Vic 3050, Australia Royal Melbourne Hosp Parkville Vic Australia 3050 le, Vic 3050, Australia
Titolo Testata:
STROKE
fascicolo: 7, volume: 32, anno: 2001,
pagine: 1581 - 1587
SICI:
0039-2499(200107)32:7<1581:PMRIMI>2.0.ZU;2-3
Fonte:
ISI
Lingua:
ENG
Soggetto:
ACUTE ISCHEMIC STROKE; APPARENT DIFFUSION-COEFFICIENT; HIGH-RESOLUTION MEASUREMENT; TRACER BOLUS PASSAGES; WEIGHTED MRI; CEREBROVASCULAR-DISEASE; DWI/PWI MISMATCH; PENUMBRA; VOLUME; HEMODYNAMICS;
Keywords:
ischemic stroke; magnetic resonance imaging, diffusion-weighted; magnetic resonance imaging, perfusion-weighted stroke outcome;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
30
Recensione:
Indirizzi per estratti:
Indirizzo: Davis, SM Royal Melbourne Hosp, Dept Neurol, Parkville, Vic 3050, Australia Royal Melbourne Hosp Parkville Vic Australia 3050 50, Australia
Citazione:
M.W. Parsons et al., "Perfusion magnetic resonance imaging maps in hyperacute stroke - Relative cerebral blood flow most accurately identifies tissue destined to infarct", STROKE, 32(7), 2001, pp. 1581-1587

Abstract

Background and Purpose-In ischemic stroke, perfusion-weighted imaging (PWI) and diffusion-weighted imaging (DWI) provide important pathophysiologicalinformation. A PWI > DWI mismatch pattern suggests the presence of salvageable tissue. However, improved methods for distinguishing PWI > DWI mismatch tissue that is critically hypoperfused from benign oligemia are required. Methods-We investigated the usefulness of maps of relative cerebral blood flow (rCBF), volume (rCBV), and mean transit time (rMTT) to predict transition to infarction in hyperacute (<6 hours) stroke patients with PWI > DWI mismatch patterns. Semiquantitative color-thresholded analysis was used to measure hypoperfusion volumes, including increasing color signal intensity thresholds of rMTT delay, which were compared with infarct expansion, outcome infarct size, and clinical status. Results-Acute rCBF lesion volume had the strongest correlation with final infarct size (r=0.91, P <0.001) and clinical outcome (r=0.67, P <0.01). There was a trend for acute rCBF > DWI mismatch volume to overestimate infarctexpansion between the acute and outcome study (P=0.06). Infarct expansion was underestimated by acute rCBV > DWI mismatch (P <0.001). When rMTT lesions included tissue with moderately prolonged transit times (mean delay 4.3 seconds, signal intensity values 50% to 70%), infarct expansion was overestimated. In contrast, when rMTT lesions were restricted to more severely prolonged transit times (mean delay 6.1 seconds, signal intensity > 70%), these regions progressed to infarction in all except 1 patient, but infarct expansion was underestimated (P <0.001). Conclusions-The acute rCBF lesion most accurately identified tissue in thePWI > DWI mismatch region at risk of infarction. Color-thresholded PWI maps show potential for use in an acute clinical setting to prospectively predict tissue outcome.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 26/01/20 alle ore 10:00:38