Reperfusion after severe local perfusion deficit precedes hemorrhagic transformation: an MRI study in acute stroke patients.
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Reperfusion after severe local perfusion deficit precedes hemorrhagic transformation: an MRI study in acute stroke patients. / Fiehler, Jens; Remmele, Christian; Kucinski, Thomas; Rosenkranz, Michael; Thomalla, Götz; Weiller, Cornelius; Zeumer, Hermann; Röther, Joachim.
in: CEREBROVASC DIS, Jahrgang 19, Nr. 2, 2, 2005, S. 117-124.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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TY - JOUR
T1 - Reperfusion after severe local perfusion deficit precedes hemorrhagic transformation: an MRI study in acute stroke patients.
AU - Fiehler, Jens
AU - Remmele, Christian
AU - Kucinski, Thomas
AU - Rosenkranz, Michael
AU - Thomalla, Götz
AU - Weiller, Cornelius
AU - Zeumer, Hermann
AU - Röther, Joachim
PY - 2005
Y1 - 2005
N2 - BACKGROUND: We applied magnetic resonance imaging to analyze the degree of local diffusion and perfusion abnormalities and the status of reperfusion in regions with subsequent hemorrhagic transformation (HT). METHODS: 51 patients with acute ischemic stroke were studied by diffusion- and perfusion-weighted imaging within 3.0 +/- 0.8 h, on day 1 and days 5-8. After realignment of the image data sets, the parameter maps of the apparent diffusion coefficient (ADC), cerebral blood flow (CBF) and cerebral blood volume (CBV), and mean transit time were analyzed in the area of subsequent HT. The degree of local diffusion and perfusion impairment in the HT area was compared with the entire diffusion and perfusion abnormality. Reperfusion status was separately assessed for the entire perfusion abnormality and the HT area. RESULTS: HT was observed in 19/51 patients (37.2%) within 8 days after symptom onset. Areas destined for HT revealed a more severe decrease in ADC (to 70 +/- 13%; p <0.01), CBV (to 31 +/- 26%; p <0.001) and CBF (to 28 +/- 19%; p <0.001) compared to the entire perfusion abnormality. Local reperfusion in the HT area was seen in 18/19 patients. The presence of HT did not coincide with a worse clinical outcome. DISCUSSION: HT is the result of reperfusion in the region with the most severe local perfusion impairment and does not influence the neurological outcome.
AB - BACKGROUND: We applied magnetic resonance imaging to analyze the degree of local diffusion and perfusion abnormalities and the status of reperfusion in regions with subsequent hemorrhagic transformation (HT). METHODS: 51 patients with acute ischemic stroke were studied by diffusion- and perfusion-weighted imaging within 3.0 +/- 0.8 h, on day 1 and days 5-8. After realignment of the image data sets, the parameter maps of the apparent diffusion coefficient (ADC), cerebral blood flow (CBF) and cerebral blood volume (CBV), and mean transit time were analyzed in the area of subsequent HT. The degree of local diffusion and perfusion impairment in the HT area was compared with the entire diffusion and perfusion abnormality. Reperfusion status was separately assessed for the entire perfusion abnormality and the HT area. RESULTS: HT was observed in 19/51 patients (37.2%) within 8 days after symptom onset. Areas destined for HT revealed a more severe decrease in ADC (to 70 +/- 13%; p <0.01), CBV (to 31 +/- 26%; p <0.001) and CBF (to 28 +/- 19%; p <0.001) compared to the entire perfusion abnormality. Local reperfusion in the HT area was seen in 18/19 patients. The presence of HT did not coincide with a worse clinical outcome. DISCUSSION: HT is the result of reperfusion in the region with the most severe local perfusion impairment and does not influence the neurological outcome.
M3 - SCORING: Zeitschriftenaufsatz
VL - 19
SP - 117
EP - 124
JO - CEREBROVASC DIS
JF - CEREBROVASC DIS
SN - 1015-9770
IS - 2
M1 - 2
ER -
