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Updated: Feb 27, 2026
A Mouse Model of Hemorrhagic Transformation Induced by Acute Hyperglycemia Combined with Transient Focal Ischemia
Published on: November 15, 2024
Cerebral hyperperfusion on arterial spin labeling MRI after reperfusion therapy is related to hemorrhagic
Shuhei Okazaki1,2, Hiroshi Yamagami1, Takeshi Yoshimoto1
11 Department of Neurology, National Cerebral and Cardiovascular Center, Suita, Japan.
Abstract:
Early detection of hemorrhagic transformation after reperfusion therapy is crucial in acute stroke treatment. Here, we evaluated the relationship between hemorrhagic transformation and post-reperfusion hyperperfusion using pulsed arterial spin labeling (ASL) perfusion MRI and 123I-iodoamphetamine single-photon emission-computed tomography. Patients who developed hemorrhagic transformation showed significantly higher cerebral blood flow in the affected lesion after thrombolysis and/or endovascular intervention. Focal hyperperfusion (ipsilateral to contralateral ratio >1.5) was associated with hemorrhagic transformation after reperfusion (odds ratio, 9.3; 95% confidence interval, 1.4-64.0). Our findings suggest that post-reperfusion hyperperfusion on ASL could represent a reliable marker of hemorrhagic transformation.
Insights
Early detection of hemorrhagic transformation (HT) after stroke reperfusion therapy is vital. Post-reperfusion hyperperfusion, identified by arterial spin labeling (ASL) MRI, is a reliable predictor of HT, aiding acute stroke treatment.
Area of Science:
- Neurology
- Radiology
- Medical Imaging
Background:
- Hemorrhagic transformation (HT) is a critical complication following acute stroke reperfusion therapy.
- Early identification of HT risk is essential for optimizing patient outcomes and treatment strategies.
Purpose of the Study:
- To investigate the association between post-reperfusion hyperperfusion and the occurrence of hemorrhagic transformation (HT) in acute stroke patients.
- To evaluate the utility of pulsed arterial spin labeling (ASL) perfusion MRI in predicting HT.
Main Methods:
- Utilized pulsed arterial spin labeling (ASL) perfusion MRI and 123I-iodoamphetamine single-photon emission-computed tomography.
- Assessed cerebral blood flow in the affected lesion post-thrombolysis and/or endovascular intervention.
- Analyzed the relationship between focal hyperperfusion (ipsilateral to contralateral ratio >1.5) and subsequent HT.
Main Results:
- Patients who developed HT exhibited significantly higher cerebral blood flow in the affected lesion after reperfusion.
- Focal hyperperfusion was strongly associated with hemorrhagic transformation (odds ratio, 9.3; 95% CI, 1.4-64.0).
Conclusions:
- Post-reperfusion hyperperfusion detected by ASL MRI serves as a reliable imaging marker for predicting hemorrhagic transformation.
- This finding can aid clinicians in managing acute stroke patients undergoing reperfusion therapy.
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