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Related Experiment Videos

Perfusion thresholds in acute stroke thrombolysis.

K Butcher1, M Parsons, T Baird

  • 1Department of Neurology, Royal Melbourne Hospital, Parkville, Victoria 3050, Australia. Kenneth.butcher@mh.org.au

Stroke
|August 2, 2003
PubMed
Summary

Mean transit time (MTT) and regional cerebral blood flow (rCBF) increases/decreases predict stroke infarction. MTT is the most useful measure for predicting tissue salvage after reperfusion in acute ischemic stroke patients.

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Area of Science:

  • Neurology
  • Radiology
  • Medical Imaging

Background:

  • Perfusion-weighted MRI aids in early identification of at-risk cerebral tissue during acute ischemia.
  • Identifying perfusion thresholds can help select acute stroke patients for thrombolysis therapy.

Purpose of the Study:

  • To evaluate the predictive value of perfusion-weighted MRI parameters for cerebral infarction and tissue salvage.
  • To determine the most clinically useful quantitative perfusion measure in acute ischemic stroke.

Main Methods:

  • Generated Mean Transit Time (MTT), regional Cerebral Blood Flow (rCBF), and regional Cerebral Blood Volume (rCBV) maps in 35 acute stroke patients within 6 hours of symptom onset.
  • Compared perfusion measures between infarcted and salvaged tissue at 90 days post-stroke.

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  • Analyzed the impact of reperfusion on tissue salvage in relation to MTT and rCBF.

    • Main Results:

    • Prolonged MTT (22%) and reduced rCBF (10%) were significantly associated with infarcted tissue.
    • rCBV did not significantly differ between infarcted and salvaged regions.
    • More severely prolonged MTT predicted tissue salvage after reperfusion, while rCBF did not show this difference.

    Conclusions:

    • Both increased MTT and decreased rCBF are predictive of infarction in acute stroke.
    • MTT is the most clinically useful perfusion measure for predicting salvage in hypoperfused tissue following reperfusion.
    • Perfusion thresholds for infarction prediction require consideration of symptom duration.