Hyperacute stroke patients and catheter thrombolysis therapy: correlation between computed tomography perfusion maps and final infarction.
OBJECTIVE
We investigated the correlation between abnormal perfusion areas by computed tomography perfusion (CTP) study of hyperacute stroke patients and the final infarction areas after intraarterial catheter thrombolysis.


METHODS
CTP study using the box-modulation transfer function (box-MTF) method based on the deconvolution analysis method was performed in 22 hyperacute stroke patients. Ischemic lesions were immediately treated with catheter thrombolysis after CTP study. Among them, nine patients with middle cerebral artery (MCA) occlusion were investigated regarding correlations of the size of the prolonged mean transit time (MTT) area, the decreased cerebral blood volume (CBV) area, and the final infarction area.


RESULTS
Using the box-MTF method, the prolonged MTT area was almost identical to the final infarction area in the case of catheter thrombolysis failure. The decreased CBV areas resulted in infarction or hemorrhage, irrespective of the outcome of recanalization after catheter thrombolysis.


CONCLUSIONS
The prolonged MTT areas, detected by the box-MTF method of CTP in hyperacute stroke patients, included the area of true prolonged MTT and the tracer delay. The prolonged MTT area was almost identical to the final infarction area when recanalization failed. We believe that a tracer delay area also indicates infarction in cases of thrombolysis failure.
Department of Radiology, Wakakusa Daiichi Hospital, 1-6 Wakakusa-cho, Higashi Osaka 579-8056, Japan. 101naito@iris.eonet.ne.jp
Yukari
Y
Naito
Shigeko
S
Tanaka
Yuichi
Y
Inoue
Shinsuke
S
Ota
Saburo
S
Sakaki
Hajime
H
Kitagaki
D000208:Acute Disease; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015901:Angiography, Digital Subtraction; D002404:Catheterization; D002560:Cerebrovascular Circulation; D005260:Female; D006801:Humans; D020244:Infarction, Middle Cerebral Artery / Q000000981:diagnostic imaging* / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D011857:Radiographic Image Interpretation, Computer-Assisted; D020521:Stroke / Q000000981:diagnostic imaging* / Q000188:drug therapy*; D015912:Thrombolytic Therapy / Q000379:methods*; D014057:Tomography, X-Ray Computed / Q000379:methods*