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Related Experiment Videos

The delayed perfusion sign at MRI.

M Hermier1, A S Ibrahim, M Wiart

  • 1(1) Service de Radiologie, Hôpital Neurologique et Neurochirurgical P. Wertheimer, BP Lyon Montchat, 69394 Lyon Cedex 03, France.

Journal of Neuroradiology = Journal De Neuroradiologie
|July 5, 2003
PubMed
Summary
This summary is machine-generated.

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Assessing leptomeningeal collateral blood flow using perfusion-weighted imaging in acute stroke patients reveals a delayed contrast filling that indicates better clinical and morphological outcomes. This finding highlights the importance of collateral circulation in stroke recovery.

Area of Science:

  • Neuroradiology
  • Neuroimaging
  • Stroke Imaging

Background:

  • Effective collateral blood flow is crucial for minimizing infarct volume and improving clinical outcomes in acute stroke.
  • Leptomeningeal collateral circulation plays a significant role in reperfusion and salvage of ischemic brain tissue.

Purpose of the Study:

  • To evaluate leptomeningeal collateral blood flow using source perfusion-weighted images (PWI) in patients with acute stroke.
  • To correlate imaging markers of collateral flow with clinical and radiological outcomes.

Main Methods:

  • 29 patients with middle cerebral artery occlusion underwent MRI, including PWI, before thrombolysis and at 60 days.
  • Assessed delayed perfusion (DP) areas on PWI source images and calculated the DP/global perfusion (GP) ratio.

Related Experiment Videos

  • Correlated DP/GP ratio with age, clinical scores (NIHSS, mRS), occlusion site, lesion size, and PWI parameters (TTP, rCBV, rCBF).

    • Main Results:

    • Delayed perfusion areas were observed in all patients within the global perfusion deficit.
    • Higher DP/GP ratios significantly correlated with better clinical scores at day 0 and day 60.
    • Higher DP/GP ratios were associated with smaller infarct volumes (DWI/T2WI), internal carotid artery patency, and favorable PWI parameters (lower TTP, higher rCBV/rCBF).

    Conclusions:

    • Delayed contrast filling on native PWI may serve as a marker for leptomeningeal collateral blood flow.
    • This imaging marker is associated with improved clinical and morphological outcomes in acute ischemic stroke.
    • These preliminary findings support the utility of PWI in assessing collateral status and predicting stroke outcomes.