doi: 10.1161/01.STR.0000032554.19600.60
(Stroke. 2002;33:2421.)
© 2002 American Heart Association, Inc.
Original Contributions |
Cerebral Blood Flow Predicts Lesion Growth in Acute Stroke Patients
From the Departments of Neuroradiology (J.F., T.K., B.E., O.W., H.Z.) and Neurology (M. von B., R.K., J.R.), University Hospital Hamburg-Eppendorf, University of Hamburg, Hamburg, Germany.
Correspondence to Jens Fiehler, MD, Department of Radiology, University Hospital Eppendorf, Martinistrasse 52, 20246 Hamburg, Germany. E-mail fiehler{at}uke.uni-hamburg.de
Background and Purpose— We sought to study the role of MRI-derived cerebral blood flow (CBF) measurements for the prediction of lesion development in acute stroke patients.
Methods— Thirty-two patients were treated with tissue plasminogen activator. Diffusion-weighted (DWI) and perfusion-weighted MRI, T2-weighted imaging, and MR angiography were performed before treatment (2.8±0.9 hours after symptom onset) and on follow-up (days 1 and 7). CBF thresholds (12 and 22 mL/100 g per minute) were applied to bolus tracking MRI maps to determine predictive cutoff levels.
Results— In 21 patients (group A), the terminal lesion volume (T2-weighted imaging) was larger than the initial DWI lesion volume (89±93 versus 21±38 mL). In 11 patients (group B), the terminal lesion volume was smaller than the initial DWI lesion volume (7±27 versus 15±29 mL). The initial DWI lesion volume did not differ between both groups. The presence of a tissue volume 
50 mL with a CBF value 
12 mL/100 g per minute was predictive for lesion enlargement to day 7 in T2-weighted imaging (positive predictive value, 0.80).
Conclusions— The presence of a tissue volume 50 mL with a CBF value 12 mL/100 g per minute predicts further lesion growth in hyperacute stroke patients. MRI-derived CBF values, with all their present limitations, are valuable in early estimation of prognosis of stroke patients.
Key Words: cerebral blood flow • magnetic resonance imaging • perfusion • stroke
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