title: Reduced rCBV ratio in perfusion-weighted MR images predicts poor outcome after thrombolysis in acute ischemic stroke.
abstract: Recent research has suggested that a perfusion-weighted image (PWI) relative cerebral blood volume (rCBV) map after acute ischemic stroke (AIS) provides information about the collateral circulation in the ischemic region. In this study, we demonstrate the usefulness of the rCBV ratio in PWI in predicting poor outcome after using IV t-PA in AIS. We recruited 58 stroke patients who were treated with IV t-PA after diagnostic magnetic resonance imaging (MRI). Poor outcome was defined as a Modified Rankin Scale (mRS) score >2 measured 90 days after ischemic insult. In total, 21 patients (36.2%) demonstrated poor outcome (i.e. mRS score 3-6). Poor outcome after t-PA correlated with age (p = 0.03), serum glucose level (p = 0.01), NIHSS (p = 0.05), and the presence of T-occlusion (p = 0.05). Poor outcome also correlated with diffusion-weighted MR images of the lesion volume (p < 0.01), lower rCBV ratio on PWI (p < 0.01), and non-recanalization (p < 0.01). Among these, non-recanalization (p < 0.01), reduced rCBV ratio on PWI (p < 0.01), age (p = 0.04), and serum glucose level (p = 0.01) had an independent significance for predicting it. This suggests that the rCBV ratio on PWI may be used to determine prognosis after thrombolysis in AIS.
authors.affiliation: Department of Neurology, Busan-Ulsan Regional Cardio-Cerebrovascular Diseases Center, Chang-Won Samsung Medical Center, Dong-A University Hospital, Republic of Korea.
authors.forename: Hyang-I
authors.initials: HI
authors.lastname: Park
authors.forename: Jae-Kwan
authors.initials: JK
authors.lastname: Cha
authors.forename: Myung-Jin
authors.initials: MJ
authors.lastname: Kang
authors.forename: Dae-Hyun
authors.initials: DH
authors.lastname: Kim
authors.forename: Nam-Tae
authors.initials: NT
authors.lastname: Yoo
authors.forename: Jae-Hyung
authors.initials: JH
authors.lastname: Choi
authors.forename: Jae-Taeck
authors.initials: JT
authors.lastname: Huh
mesh_terms: D000368:Aged; D000704:Analysis of Variance; D002560:Cerebrovascular Circulation / Q000187:drug effects / Q000502:physiology*; D038524:Diffusion Magnetic Resonance Imaging / Q000379:methods*; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D020521:Stroke / Q000503:physiopathology / Q000628:therapy*; D015912:Thrombolytic Therapy / Q000009:adverse effects*; D010959:Tissue Plasminogen Activator / Q000627:therapeutic use*
chemical_list: D010959:Tissue Plasminogen Activator