How Sustained Is 24-Hour Diffusion-Weighted Imaging Lesion Reversal? Serial Magnetic Resonance Imaging in a Patient Cohort Thrombolyzed Within 4.5 Hours of Stroke Onset
How Sustained Is 24-Hour Diffusion-Weighted Imaging Lesion Reversal? Serial Magnetic Resonance Imaging in a Patient Cohort Thrombolyzed Within 4.5 Hours of Stroke Onset
复制标题
DOI：
10.1161/strokeaha.114.008322
复制
发表时间：
2015-03-01
期刊：
影响因子：
8.3
通讯作者：
Oppenheim, Catherine
中科院分区：
文献类型：
--
作者：
Soize, Sebastien;Tisserand, Marie;Oppenheim, Catherine
背景和目的：在这里，我们评估了静脉溶栓后24小时观察到的急性弥漫性病变（RAD）逆转的持续时间，以及RAD命运与早期神经系统改善之间的关系。方法：我们分析了155例中风发作后152分钟静脉溶栓的连续患者，他们接受了3次MR治疗：治疗前1次，治疗后2次（从发作开始的中位时间分别为25.6和54.3小时）。使用基于体素的弥散加权成像（DWI）(1)、DWI2和DWI 3病变在共配图像数据集上的分析，我们评估了RAD体素的结果（DWI1高但DWI2不高）在DWI 3上是短暂的还是持续的，以及它们与早期神经系统改善的关系，定义为Delta国立卫生研究院卒中量表>= 8或国立卫生研究院卒中量表= 10 mL。与短暂性RAD体素相比，持续RAD体素的基线表观扩散系数值（中位数[四分位数范围]为793[717-887]，而不是777 [705-869]× 10(-6) mm）(2)。分别是(1);P=0.08)，且灌注明显改善(T-max，平均+/- SD， 6.3 +/- 3.2 vs 7.8 +/- 4.0 s
Background and Purpose-Here, we assessed how sustained is reversal of the acute diffusion lesion (RAD) observed 24 hours after intravenous thrombolysis, and the relationships between RAD fate and early neurological improvement.Methods-We analyzed 155 consecutive patients thrombolyzed intravenously 152 minutes (median) after stroke onset and who underwent 3 MR sessions: 1 before and 2 after treatment (median times from onset, 25.6 and 54.3 hours, respectively). Using voxel-based analysis of diffusion-weighted imaging (DWI)(1), DWI2, and DWI 3 lesions on coregistered image data sets, we assessed the outcome of RAD voxels (hyperintense on DWI1 but not on DWI2) as transient or sustained on DWI 3, and their relationships with early neurological improvement, defined as Delta National Institutes of Health Stroke Scale >= 8 or National Institutes of Health Stroke Scale = 10 mL. As compared with transient RAD voxels, sustained RAD voxels had nonsignificantly higher baseline apparent diffusion coefficient values (median [interquartile range], 793 [717-887] versus 777 [705-869]x10(-6) mm(2).s(-1), respectively; P=0.08) and significantly better perfusion (T-max, mean +/- SD, 6.3 +/- 3.2 versus 7.8 +/- 4.0 s; P