title: Evaluation of the role of susceptibility-weighted imaging in thrombolytic therapy for acute ischemic stroke.
abstract: We inspected low-intensity venous signals and microbleeds in patients with acute ischemic stroke (AIS) using susceptibility-weighted imaging (SWI) before and after administration of within-thrombolytic-time-window thrombolytic therapies, and observed their prognosis and safety, in order to guide individualized thrombolytic therapies. Patients with AIS were divided into groups A or B according to the presence of symmetric or asymmetric veins on SWI, and were re-inspected by SWI after intravenous thrombolysis using recombinant tissue plasminogen activator (rt-PA). The National Institutes of Health stroke scale (NIHSS) score before treatment and at 1-h and 24-h posttreatment in the two groups were 11.9, 7.3, and 7.1 in group A, 12.4, 8.2, and 7.9 in group B, significant difference was detected between the two groups after treatment. The 90-day mortality rate was 0, and the incidences of cerebral microbleeds (CMBs) and symptomatic cerebral hemorrhage (SCH) were 17.6%, and 0% in group A, 25.6% and 0% in group B, respectively. The incidences of CMBs and SCH in group A were lower than those in group B, but the intergroup differences were not statistically significant (P>0.05). The 90-day neurological improvement rates in the two groups were 70.2% and 58.1%, respectively, and group A showed a significantly better prognosis than group B (P<0.05). Thus, low-intensity venous signals in SWI can be used to evaluate a low level of perfusion, post-thrombolytic prognosis, and bleeding indexes, and can therefore be used to guide individualized thrombolytic therapies.
authors.affiliation: Department of Neurology, Linyi People's Hospital, Linyi 276000, China.
authors.forename: Guangjian
authors.initials: G
authors.lastname: Zhao
authors.affiliation: Department of Neurology, Linyi People's Hospital, Linyi 276000, China.
authors.forename: Ling
authors.initials: L
authors.lastname: Sun
authors.affiliation: Department of Neurology, Linyi People's Hospital, Linyi 276000, China. Electronic address: docziranwang@163.com.
authors.forename: Ziran
authors.initials: Z
authors.lastname: Wang
authors.affiliation: Department of Neurology, Linyi People's Hospital, Linyi 276000, China.
authors.forename: Liquan
authors.initials: L
authors.lastname: Wang
authors.affiliation: Department of Neurology, Linyi People's Hospital, Linyi 276000, China.
authors.forename: Zhongrong
authors.initials: Z
authors.lastname: Cheng
authors.affiliation: Department of Neurology, Linyi People's Hospital, Linyi 276000, China.
authors.forename: Hongyan
authors.initials: H
authors.lastname: Lei
authors.affiliation: Department of Neurology, Linyi People's Hospital, Linyi 276000, China.
authors.forename: Daiqun
authors.initials: D
authors.lastname: Yang
authors.affiliation: Department of Neurology, Linyi People's Hospital, Linyi 276000, China.
authors.forename: Yansen
authors.initials: Y
authors.lastname: Cui
authors.affiliation: Department of Neurology, Linyi People's Hospital, Linyi 276000, China.
authors.forename: Shirui
authors.initials: S
authors.lastname: Zhang
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002545:Brain Ischemia / Q000000981:diagnostic imaging* / Q000188:drug therapy; D005260:Female; D005343:Fibrinolytic Agents / Q000008:administration & dosage / Q000627:therapeutic use; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D020521:Stroke / Q000000981:diagnostic imaging* / Q000188:drug therapy; D015912:Thrombolytic Therapy / Q000009:adverse effects / Q000379:methods*; D010959:Tissue Plasminogen Activator / Q000008:administration & dosage / Q000627:therapeutic use
chemical_list: D005343:Fibrinolytic Agents; D010959:Tissue Plasminogen Activator
keywords: Acute ischemic stroke; Intravenous thrombolysis; Microbleeds; Susceptibility weighted imaging; Venous asymmetry