Ａｐｐａｒｅｎｔ ｄｉｆｆｕｓｉｏｎ ｃｏｅｆｆｉｃｉｅｎｔを用いた急性期脳虚血領域の可逆性評価
スポンサーリンク
概要
- 論文の詳細を見る
Assessment of the viability of ischemic regions in hyperacute stroke is required for decision-making in thrombolytic therapy. We investigated the efficacy of apparent diffusion coefficient (ADC) in assessing tissue viability of ischemic regions. Subjects comprised 12 patients with middle cerebral artery M1 occlusion. Ten patients underwent intra-arterial thrombolysis and 2 patients received conservative therapies. On acute diffusion-weighted images, affected regions were classified into 3 groups: hyperintense area (HA), slightly hyperintense area (SHA) or isointense area (IA). ADC ratio (rADC) was calculated and reperfusion was assessed for each area. The rADC values in SHAs (0.80±0.10) were significantly lower than those in IAs (0.99±0.11, p<<0.001) but were significantly higher than those in HAs (0.66±0.09, p<0.001). In recanalized areas, all HAs resulted in infarction, but no IAs resulted in infarction. All SHAs with rADC <0.77 resulted in infarction, and no SHAs with rADC≥0.77 resulted in infarction. Among reperfused areas, an rADC of 0.77 was the cutoff value between reversible and irreversible lesions (sensitivity, 100%; specificity, 100%). Among non-reperfused areas, no apparent rADC threshold was found between areas that became infarcted and that those did not. In conclusion, the present results suggest that reversibility of ischemic lesions with slight signal hyperintensity on DWI can be quantitatively predicted by measuring rADC. Assessments based on ADC may be useful for determining indications for thrombolytic therapy.
- 一般社団法人 日本脳卒中の外科学会の論文
一般社団法人 日本脳卒中の外科学会 | 論文
- 頸部内頸動脈のｎｅａｒ ｏｃｃｌｕｓｉｏｎに対するＳＴＡ‐ＭＣＡ吻合術
- 未破裂脳動脈瘤の外科手術の合併症とその対策―慢性硬膜下血腫および後頭蓋窩出血の発生予防―:―慢性硬膜下血腫および後頭蓋窩出血の発生予防―
- 周術期管理指針に基づいたもやもや病に対する血行再建術:―急性期脳血流評価と予防的降圧の効果と限界―
- 未破裂脳動脈瘤クリッピング術の治療成績‐脳動脈瘤手術初心者の経験‐:―脳動脈瘤手術初心者の経験―
- 脳底動脈上小脳動脈分岐部動脈りゅう５８手術例の検討