Comparison of fast MRI-based individual thrombolysis therapy for patients with superacute infarction.
BACKGROUND
The aim of this study is to investigate the outcomes of magnetic resonance imaging (MRI)-based individual thrombolysis therapy using recombinant tissue plasminogen activator (rt-PA) in patients with superacute infarction, comparing the outcome in 1 group of patients treated within 4.5 hours compared with 4.5- to 12-hour window treatment group.


METHODS
We studied 135 patients stratified to 2 different groups based on whether they presented with stroke symptoms within 4.5 hours (4.5-hour group, 72 patients) or between 4.5 and 12 hours (4.5- to 12-h group, 63 patients). All patients were treated with rt-PA after MRI confirmed superacute ischemic stroke (hyperintense in diffusion-weighted imaging but no hypointense change in T2-weighted image (T2WI) or fluid-attenuated inversion recovery). Clinical neurologic deficit was evaluated using the National Institutes of Health Stroke Scale on admission, at 24 hours, and 7 days later. A 90-day clinical outcome was assessed using the modified Rankin Scale (mRS).


RESULTS
There was no significant difference in the clinical outcome between the patients treated with thrombolysis within the first 4.5 hours and those treated between 4.5 and 12 hours. The 2 groups both had recanalization, mRS, and favorable outcome at 90 days (P > .05).


CONCLUSIONS
Our study suggested that fast MR-based thrombolysis using rt-PA was safe and reliable in superacute infarction within 4.5 hours and 4.5-12 hours poststroke.
Department of Neurology, Pudong People's Hospital, Shanghai, China.
Qingke
Q
Bai
Department of Radiology, Pudong People's Hospital, Shanghai, China. Electronic address: zhaozhenguo1@sina.com.
Zhenguo
Z
Zhao
Department of Radiology, Pudong People's Hospital, Shanghai, China.
Haijing
H
Sui
Department of Radiology, Pudong People's Hospital, Shanghai, China.
Xiuhai
X
Xie
Department of Neurology, Pudong People's Hospital, Shanghai, China.
Juan
J
Chen
Department of Neurology, Pudong People's Hospital, Shanghai, China.
Juan
J
Yang
Department of Neurology, Pudong People's Hospital, Shanghai, China.
Yuan
Y
Zhou
D000208:Acute Disease; D000368:Aged; D000369:Aged, 80 and over; D002544:Cerebral Infarction / Q000188:drug therapy*; D042241:Early Diagnosis; D005260:Female; D005343:Fibrinolytic Agents / Q000627:therapeutic use; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D015912:Thrombolytic Therapy / Q000379:methods*; D010959:Tissue Plasminogen Activator / Q000627:therapeutic use; D016896:Treatment Outcome
D005343:Fibrinolytic Agents; D010959:Tissue Plasminogen Activator
Magnetic resonance imaging; recombinant tissue plasminogen activator; stroke; thrombolysis