title: Relative CBV ratio on perfusion-weighted MRI indicates the probability of early recanalization after IV t-PA administration for acute ischemic stroke.
abstract: BACKGROUND
  We hypothesized that the relative cerebral blood volume (rCBV) ratio on perfusion-weighted imaging (PWI) using MRI might serve as a predictor of early recanalization (ER) after intravenous tissue plasminogen activator (IV t-PA) administration for acute ischemic stroke.
  
  
  METHODS
  Patients with acute middle cerebral artery (MCA) ischemic stroke (IS) were enrolled in the study. They were evaluated by MRI, including PWI and diffusion-weighted imaging, before administration of IV t-PA and underwent digital subtraction angiography (DSA) of the brain within 2 h after t-PA administration. We compared the rCBV ratio on PWI between patients with and without ER on DSA and investigated the proportion of patients with an excellent outcome at 90 days after t-PA administration (modified Rankin Scale score 0-1) among those with and without ER.
  
  
  RESULTS
  85 patients with acute MCA IS were included; 16 patients (18.8%) experienced ER on DSA after IV t-PA administration. Patients with ER more frequently had an excellent outcome at 90 days than those without ER. The rCBV ratio on PWI was higher in the ER group (1.01±0.21, p<0.01) than in the non-ER group (0.82±0.18). After adjusting for the presence of atrial fibrillation and the serum glucose level, the rCBV ratio on PWI (OR 1.07; 95% CI 1.02 to 1.12; p<0.01) was a significant independent indicator of ER.
  
  
  CONCLUSIONS
  The results of this study suggest that the rCBV ratio on PWI might serve as a useful indicator of ER after IV t-PA administration.
authors.affiliation: Busan-Ulsan Regional Cardio-Cerebral Vascular Center, Dong-A University Hospital, Busan, Korea.
authors.forename: Sang-Wook
authors.initials: SW
authors.lastname: Sohn
authors.affiliation: Busan-Ulsan Regional Cardio-Cerebral Vascular Center, Dong-A University Hospital, Busan, 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, Korea.
authors.forename: Jae-Kwan
authors.initials: JK
authors.lastname: Cha
authors.affiliation: Busan-Ulsan Regional Cardio-Cerebral Vascular Center, Dong-A University Hospital, Busan, 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, Korea.
authors.forename: Myung-Jin
authors.initials: MJ
authors.lastname: Kang
authors.affiliation: Busan-Ulsan Regional Cardio-Cerebral Vascular Center, Dong-A University Hospital, Busan, 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, Korea.
authors.forename: Hyun-Wook
authors.initials: HW
authors.lastname: Nah
authors.affiliation: Busan-Ulsan Regional Cardio-Cerebral Vascular Center, Dong-A University Hospital, Busan, Korea.
authors.forename: Jae-Taeck
authors.initials: JT
authors.lastname: Huh
mesh_terms: D000368:Aged; D001810:Blood Volume / Q000187:drug effects / Q000502:physiology*; D002545:Brain Ischemia / Q000175:diagnosis / Q000188:drug therapy / Q000503:physiopathology*; D002560:Cerebrovascular Circulation / Q000187:drug effects / Q000502:physiology*; D005260:Female; D006801:Humans; D007262:Infusions, Intravenous; D018810:Magnetic Resonance Angiography / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011336:Probability; D015424:Reperfusion / Q000379:methods; D012189:Retrospective Studies; D020521:Stroke / Q000175:diagnosis / Q000188:drug therapy / Q000503:physiopathology*; D010959:Tissue Plasminogen Activator / Q000008:administration & dosage*
chemical_list: D010959:Tissue Plasminogen Activator
keywords: MR perfusion; Stroke; Thrombolysis