title: The rCBV ratio on perfusion-weighted imaging reveals the extent of blood flow on conventional angiography after acute ischemic stroke.
abstract: OBJECTIVE
  In this study, we evaluated the relationship between the rCBV (regional cerebral blood flow volume) ratio on perfusion-weighted imaging (PWI) and the extent of collateral flow on conventional angiography.
  
  
  METHODS
  We recruited 98 patients with AIS (within 24h after ischemic events). All the patients were evaluated by MRI, including PWI and diffusion-weighted imaging (DWI), and underwent digital subtraction angiography (DSA) of the brain. We hypothesized that the rCBV ratio on PWI could reveal the extent of the blood flow and predict early neurological deterioration (END) within 7 days after AIS.
  
  
  RESULTS
  The rCBV ratio on PWI was significantly correlated with its extent on DSA (p<0.01). During the observation period, 24 patients (24.5%) experienced END. The univariate analysis revealed that severe neurological deficit at admission (p<0.01), the volume of the ischemic lesion on DWI (p<0.01), poor blood flow on DSA (p<0.01), the presence of DPM (p=0.05) and a low rCBV ratio on PWI (p<0.01) were related to END occurrence. The multivariate analysis showed that the presence of a low rCBV ratio on PWI was independently significant as a correlate of END (OR, 5.64; 95% CI, 1.68-18.90; p<0.01).
  
  
  CONCLUSIONS
  This study shows that the rCBV ratio on PWI may be a useful tool to reveal the status of blood flow after AIS. Moreover, the extent of collateral flow may be an important parameter that subtly influences the fate of DPM in AIS.
authors.affiliation: Busan-Ulsan Regional Cardio-Cerebral Vascular Center, Dong-A University Hospital, Busan, Republic of Korea.
authors.forename: Hyun-Seok
authors.initials: HS
authors.lastname: Park
authors.affiliation: Busan-Ulsan Regional Cardio-Cerebral Vascular Center, Dong-A University Hospital, Busan, Republic of Korea. Electronic address: nrcjk65@gmail.com.
authors.forename: Jae-Kwan
authors.initials: JK
authors.lastname: Cha
authors.affiliation: Busan-Ulsan Regional Cardio-Cerebral Vascular Center, Dong-A University Hospital, Busan, Republic of Korea.
authors.forename: Dae-Hyun
authors.initials: DH
authors.lastname: Kim
authors.affiliation: Busan-Ulsan Regional Cardio-Cerebral Vascular Center, Dong-A University Hospital, Busan, Republic of Korea.
authors.forename: Myong-Jin
authors.initials: MJ
authors.lastname: Kang
authors.affiliation: Busan-Ulsan Regional Cardio-Cerebral Vascular Center, Dong-A University Hospital, Busan, Republic of Korea.
authors.forename: Jae-Hyung
authors.initials: JH
authors.lastname: Choi
authors.affiliation: Busan-Ulsan Regional Cardio-Cerebral Vascular Center, Dong-A University Hospital, Busan, Republic of Korea.
authors.forename: Jae-Taeck
authors.initials: JT
authors.lastname: Huh
mesh_terms: D000368:Aged; D015901:Angiography, Digital Subtraction / Q000592:standards*; D002545:Brain Ischemia / Q000175:diagnosis* / Q000000981:diagnostic imaging; D002560:Cerebrovascular Circulation / Q000502:physiology*; D038524:Diffusion Magnetic Resonance Imaging / Q000592:standards; D005260:Female; D006801:Humans; D018810:Magnetic Resonance Angiography / Q000592:standards; D008279:Magnetic Resonance Imaging / Q000592:standards*; D008297:Male; D008875:Middle Aged; D055420:Perfusion Imaging / Q000592:standards; D020521:Stroke / Q000175:diagnosis* / Q000000981:diagnostic imaging
keywords: Collateral flow; Magnetic resonance imaging; Perfusion; Stroke