期刊
NEUROIMAGE-CLINICAL
卷 37, 期 -, 页码 -出版社
ELSEVIER SCI LTD
DOI: 10.1016/j.nicl.2023.103340
关键词
Arterial spin labeling; Cerebral blood flow; Hyperperfusion; Large vessel occlusion; Ischemic stroke
类别
Restoring blood flow is crucial for tissue survival and clinical outcome in ischemic stroke patients. Using ASL MRI, we found that hyperperfusion frequently occurs in infarcted and salvaged brain tissue following successful recanalization. Higher reperfusion levels are associated with better early neurological outcomes.
Restoring blood flow to brain tissue at risk of infarction is essential for tissue survival and clinical outcome. We used cerebral blood flow (CBF) quantified with multiple post-labeling delay (PLD) pseudocontinuous arterial spin labeling (ASL) MRI after ischemic stroke and assessed the association between CBF and early neurological outcome. We acquired ASL with 7 PLDs at 3.0 T in large vessel occlusion stroke patients at 24 h. We quantified CBF relative to the contralateral hemisphere (rCBF) and defined hyperperfusion as a >= 30% increase and hypoperfusion as a >= 40% decrease in rCBF. We included 44 patients (median age: 70 years, median NIHSS: 13, 40 treated with endovascular thrombectomy) of whom 37 were recanalized. Hyperperfusion in ischemic core occurred in recanalized but not in non-recanalized patients (65.8% vs 0%, p = 0.006). Hypoperfusion occurred only in the latter group (0% vs 85.7%, p < 0.001). In recanalized patients, hyperperfusion was also seen in salvaged penumbra (38.9%). Higher rCBF in ischemic core (a beta,-2.75 [95% CI:-4.11 to-1.401) and salvaged penumbra (a beta,-5.62 [95% CI:-9.57 to-1.681) was associated with lower NIHSS scores at 24 h. In conclusion, hyperperfusion frequently occurs in infarcted and salvaged brain tissue following successful recanalization and early neurological outcome is positively associated with the level of reperfusion.
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