Evolution of lesion volume in acute stroke treated by intravenous t-PA.
OBJECTIVE
To determine the evolution of the ischemic lesion volumes in a population treated with tissue plasminogen activator (t-PA), MRIs were performed before treatment and 24 hours later; final infarct size was evaluated 60 days later.


METHODS
A total of 42 patients with hemispheric stroke were recruited for a thrombolytic study. Intravenous t-PA was given after MRI within the first seven hours after stroke onset. Volumes were evaluated on day 0 and day 1 with diffusion-weighted imaging (DWI), on day 60 with T2-weighted imaging (T2WI), and recanalization was assessed based on day 1 MR angiography (MRA).


RESULTS
Lesion volume increased between day 0 and day 1, and decreased between day 1 and day 60. It was lower in the group of patients with recanalization on day 1 MRA.


CONCLUSIONS
Volume analysis emphasizes the effectiveness of recanalization as a predictive factor for better outcome, based on final infarct size. The decrease in lesion volumes between day 1 and day 60 suggests that other factors leads to overestimation of day 1 abnormal diffusion volume. This could explain the delayed partial reversibility of the DWI abnormality.
Pialat
Jean-Baptiste
JB
Laboratoire CREATIS, Unité Médicale de Recherche CNRS 5515 Unité 630 INSERM, Lyon, France. jean-baptiste.pialat@chu-lyon.fr
Wiart
Marlene
M
Nighoghossian
Norbert
N
Adeleine
Patrice
P
Derex
Laurent
L
Hermier
Marc
M
Froment
Jean-Claude
JC
Berthezene
Yves
Y
D001921:Brain / Q000473:pathology; D038524:Diffusion Magnetic Resonance Imaging; D006801:Humans; D015203:Reproducibility of Results; D020521:Stroke / Q000188:drug therapy* / Q000473:pathology*; D010959:Tissue Plasminogen Activator / Q000627:therapeutic use*
D010959:Tissue Plasminogen Activator