Prediction of Early Reperfusion From Repeated Arterial Spin Labeling Perfusion Magnetic Resonance Imaging During Intravenous Thrombolysis
- 1 January 2016
- journal article
- research article
- Published by Ovid Technologies (Wolters Kluwer Health) in Stroke
- Vol. 47 (1), 247-250
- https://doi.org/10.1161/strokeaha.115.011482
Abstract
Background and Purpose—: There are few in vivo data on the pathophysiology of reperfusion during systemic thrombolysis. We monitored the time course of cerebral perfusion changes in patients during thrombolysis with repeated arterial spin labeling perfusion magnetic resonance imaging. Methods—: Ten patients with proximal arterial occlusion within 4.5 hours after symptom onset were prospectively enrolled. All patients received intravenous thrombolysis during the magnetic resonance imaging examination. Repeated arterial spin labeling perfusion images were acquired during the 60-minute therapy and at follow-up after 24 to 72 hours. Clinical data, magnetic resonance imaging features, and cerebral perfusion changes were analyzed. Results—: Before thrombolysis, arterial spin labeling hypoperfusion and fluid-attenuation inversion recovery vascular hyperintensity in the territory of the occluded arteries were observed in all patients. In 5 patients, extensive arterial transit artifacts (ATA) developed in the hypoperfused area. The ATA corresponded with fluid-attenuation inversion recovery vascular hyperintensities. All 5 patients who developed extensive ATA in the hypoperfused area had complete reperfusion after thrombolysis, whereas the 5 without extensive ATA showed no or only partial reperfusion ( P <0.01). The development of ATA preceded the normalization of tissue perfusion. Conclusions—: The development of ATA during thrombolysis is associated with early reperfusion after thrombolysis. arterial spin labeling assessment during intravenous thrombolysis has the potential to guide subsequent therapeutic strategies in patients with acute stroke.Keywords
This publication has 10 references indexed in Scilit:
- Acute Stroke InterventionJama-Journal Of The American Medical Association, 2015
- Bright Vessel Appearance on Arterial Spin Labeling MRI for Localizing Arterial Occlusion in Acute Ischemic StrokeStroke, 2015
- Operator-bias-free Comparison of Quantitative Perfusion Maps Acquired with Pulsed-continuous Arterial Spin Labeling and Single-photon-emission Computed TomographyMagnetic Resonance in Medical Sciences, 2014
- Continuous Magnetic Resonance Perfusion Imaging Acquisition during Systemic Thrombolysis in Acute StrokeCerebrovascular Diseases, 2013
- Can Restoring Incomplete Microcirculatory Reperfusion Improve Stroke Outcome after Thrombolysis?Journal of Cerebral Blood Flow & Metabolism, 2012
- Arterial Spin-Labeling MRI Can Identify the Presence and Intensity of Collateral Perfusion in Patients With Moyamoya DiseaseStroke, 2011
- Quantification Issues in Arterial Spin Labeling Perfusion Magnetic Resonance ImagingTopics in Magnetic Resonance Imaging, 2010
- Pulsed arterial spin labeling parameter optimization for an elderly populationJournal of Magnetic Resonance Imaging, 2006
- Single‐shot 3D imaging techniques improve arterial spin labeling perfusion measurementsMagnetic Resonance in Medicine, 2005
- Magnetic Resonance Perfusion Imaging in Acute Ischemic Stroke Using Continuous Arterial Spin LabelingStroke, 2000