Diagnosis of Acute Ischemic Stroke Based on Time-To-Peak and Diffusion-Weighted Magnetic Resonance Imaging

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Rapid and accurate diagnosis of the hemodynamics of the brain is essential for the treatment of acute ischemic stroke. This study investigated whether time-to-peak and diffusion-weighted magnetic resonance (MR) imaging are useful for predicting the course of stroke. Fourteen patients with non-lacunar acute ischemic stroke underwent emergent MR imaging within 24 hours from the onset followed by cerebral angiography and xenon-enhanced computed tomography (CT). Serial CT was obtained to monitor changes in the size and nature of the infarct. Volumes of the abnormal lesions demonstrated on time-to-peak (V_T) or diffusion-weighted (V_D) images were measured, and the ratio of V_T to V_D was calculated. Based on this ratio, patients were classified into three groups: Group 1 (V_T/V_D 0.5-1.5,n=9), Group 2 (V_T/V_D>1.5,n=3), and Group 3 (V_T/V_D<0.5,n=2). The size of the infarct detected as a low-density area on serial CT scans did not change significantly throughout the course in Group 1 patients, but showed enlargement in all three patients in Group 2. Two patients in Group 3 had major trunk occlusion followed by spontaneous reperfusion, and both developed hemorrhagic transformation. Our study showed that classification of ischemic stroke based on the V_T/V_D ratio was predictive of the time course of the infarct, and may be useful in selecting the initial therapeutic procedure immediately after the onset of stroke.
日本脳神経外科学会の論文
2002-07-15

Diagnosis of Acute Ischemic Stroke Based on Time-To-Peak and Diffusion-Weighted Magnetic Resonance Imaging

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