Perfusion-Weighted MRI Parameters for Prediction of Early Progressive Infarction in Middle Cerebral Artery Occlusion.
10.3340/jkns.2016.59.4.346
- Author:
Hoon KIM
1
;
Yerim KIM
;
Young Woo KIM
;
Seong Rim KIM
;
Seung Ho YANG
Author Information
1. Department of Neurosurgery, Bucheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Suwon, Korea.
- Publication Type:Original Article
- Keywords:
Acute ischemic stroke;
Cerebral blood volume;
Hemodynamic failure;
Magnetic resonance imaging;
Middle cerebral artery occlusion
- MeSH:
Cerebrovascular Circulation;
Diabetes Mellitus;
Hospitalization;
Humans;
Incidence;
Infarction*;
Infarction, Middle Cerebral Artery*;
Magnetic Resonance Imaging*;
Middle Cerebral Artery*;
National Institutes of Health (U.S.);
Perfusion;
Retrospective Studies;
Stroke
- From:Journal of Korean Neurosurgical Society
2016;59(4):346-351
- CountryRepublic of Korea
- Language:English
-
Abstract:
OBJECTIVE: Early progressive infarction (EPI) is frequently observed and related to poor functional outcome in patients with middle cerebral artery (MCA) infarction caused by MCA occlusion. We evaluated the perfusion parameters of magnetic resonance imaging (MRI) as a predictor of EPI. METHODS: We retrospectively analyzed patients with acute MCA territory infarction caused by MCA occlusion. EPI was defined as a National Institutes of Health Stroke Scale increment ≥2 points during 24 hours despite receiving standard treatment. Regional parameter ratios, such as cerebral blood flow and volume (rCBV) ratio (ipsilateral value/contralateral value) on perfusion MRI were analyzed to investigate the association with EPI. RESULTS: Sixty-four patients were enrolled in total. EPI was present in 18 (28%) subjects and all EPI occurred within 3 days after hospitalization. Diabetes mellitus, rCBV ratio and regional time to peak (rTTP) ratio showed statically significant differences in both groups. Multi-variate analysis indicated that history of diabetes mellitus [odds ratio (OR), 6.13; 95% confidence interval (CI), 1.55-24.24] and a low rCBV ratio (rCBV, <0.85; OR, 6.57; 95% CI, 1.4-30.27) was significantly correlated with EPI. CONCLUSION: The incidence of EPI is considerable in patients with acute MCA territory infarction caused by MCA occlusion. We suggest that rCBV ratio is a useful neuro-imaging parameter to predict EPI.
