title: Baseline collateral status and infarct topography in post-ischaemic perilesional hyperperfusion: An arterial spin labelling study.
abstract: Focal hyperperfusion after acute ischaemic stroke could be of prognostic value depending upon its spatial localisation and temporal dynamics. Factors associated with late stage (12-24 h) perilesional hyperperfusion, identified using arterial spin labelling, are poorly defined. A prospective cohort of acute ischaemic stroke patients presenting within 4.5 h of symptom onset were assessed with multi-modal computed tomography acutely and magnetic resonance imaging at 24 ± 8 h. Multivariate logistic regression analysis and receiver operating characteristics curves were used. One hundred and nineteen hemispheric acute ischaemic stroke patients (mean age = 71 ± 12 years) with 24 h arterial spin labelling imaging were included. Forty-two (35.3%) patients showed perilesional hyperperfusion on arterial spin labelling at 24 h. Several factors were independently associated with perilesional hyperperfusion: good collaterals (71% versus 29%, P < 0.0001; OR = 5, 95% CI = [1.6, 15.7], P = 0.005), major reperfusion (81% versus 48%, P = < 0.0001; OR = 7.5, 95% CI = [1.6, 35.1], P = 0.01), penumbral salvage (76.2% versus 47%, P = 0.002; OR = 6.6, 95% CI = [1.8, 24.5], P = 0.004), infarction in striatocapsular (OR = 9.5, 95% CI = [2.6, 34], P = 0.001) and in cortical superior division middle cerebral artery (OR = 4.7, 95% CI = [1.4, 15.7], P = 0.012) territory. The area under the receiver operating characteristic curve was 0.91. Our results demonstrate good arterial collaterals, major reperfusion, penumbral salvage, and infarct topographies involving cortical superior middle cerebral artery and striatocapsular are associated with perilesional hyperperfusion.
authors.affiliation: 1 Department of Neurology, John Hunter Hospital, University of Newcastle, Newcastle, Australia.|2 Centre for Translational Neuroscience and Mental Health, School of Health Sciences and Hunter Medical Research Institute, University of Newcastle, Newcastle, Australia.
authors.forename: Sonu
authors.initials: S
authors.lastname: Bhaskar
authors.affiliation: 1 Department of Neurology, John Hunter Hospital, University of Newcastle, Newcastle, Australia.
authors.forename: Andrew
authors.initials: A
authors.lastname: Bivard
authors.affiliation: 2 Centre for Translational Neuroscience and Mental Health, School of Health Sciences and Hunter Medical Research Institute, University of Newcastle, Newcastle, Australia.
authors.forename: Peter
authors.initials: P
authors.lastname: Stanwell
authors.affiliation: 1 Department of Neurology, John Hunter Hospital, University of Newcastle, Newcastle, Australia.|2 Centre for Translational Neuroscience and Mental Health, School of Health Sciences and Hunter Medical Research Institute, University of Newcastle, Newcastle, Australia.
authors.forename: Mark
authors.initials: M
authors.lastname: Parsons
authors.affiliation: 3 Centre for Clinical Epidemiology & Biostatistics, Hunter Medical Research Institute, University of Newcastle, Newcastle, Australia.
authors.forename: John R
authors.initials: JR
authors.lastname: Attia
authors.affiliation: 2 Centre for Translational Neuroscience and Mental Health, School of Health Sciences and Hunter Medical Research Institute, University of Newcastle, Newcastle, Australia.|4 Centre for Brain Repair and Rehabilitation, Institute of Neuroscience and Physiology, Sahlgrenska University Hospital, University of Gothenburg, Gothenburg, Sweden.
authors.forename: Michael
authors.initials: M
authors.lastname: Nilsson
authors.affiliation: 1 Department of Neurology, John Hunter Hospital, University of Newcastle, Newcastle, Australia.|2 Centre for Translational Neuroscience and Mental Health, School of Health Sciences and Hunter Medical Research Institute, University of Newcastle, Newcastle, Australia.
authors.forename: Christopher
authors.initials: C
authors.lastname: Levi
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002545:Brain Ischemia / Q000000981:diagnostic imaging* / Q000503:physiopathology; D002560:Cerebrovascular Circulation; D015331:Cohort Studies; D003097:Collateral Circulation / Q000502:physiology*; D006801:Humans; D018810:Magnetic Resonance Angiography; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D020768:Middle Cerebral Artery / Q000503:physiopathology; D011446:Prospective Studies; D013113:Spin Labels; D014057:Tomography, X-Ray Computed
chemical_list: D013113:Spin Labels
keywords: Stroke; arterial spin labelling; collaterals; hyperperfusion; perfusion imaging; topography