Monitoring Intravenous Recombinant Tissue Plasminogen Activator Thrombolysis for Acute Ischemic Stroke With Diffusion and Perfusion MRI

医学 溶栓 改良兰金量表 冲程(发动机) 磁共振成像 灌注 病变 组织纤溶酶原激活剂 灌注扫描 脑缺血 缺血 放射科 核医学 内科学 外科 缺血性中风 工程类 心肌梗塞 机械工程
作者
Peter D. Schellinger,Olav Jansen,Jochen B. Fiebach,Sabine Heiland,Thorsten Steiner,Stefan Schwab,Olivia Pohlers,H. Ryssel,K. Sartor,Werner Hacke
出处
期刊:Stroke [Lippincott Williams & Wilkins]
卷期号:31 (6): 1318-1328 被引量:161
标识
DOI:10.1161/01.str.31.6.1318
摘要

Intravenous recombinant tissue plasminogen activator (rtPA) administration is an effective therapy for ischemic stroke when initiated within 3 hours and possibly up to 6 hours after symptom onset. To improve patient selection, a fast diagnostic tool that allows reliable diagnosis of hemorrhage and ischemia, vessel status, and tissue at risk at an early stage may be useful. We studied the feasibility of stroke MRI for the initial evaluation and follow-up monitoring of patients undergoing intravenous thrombolysis.Stroke MRI (diffusion- and perfusion-weighted imaging [DWI and PWI, respectively], magnetic resonance angiography, and T2-weighted imaging) was performed before, during, or after thrombolysis and on days 2 and 5. We assessed clinical scores (National Institutes of Health Stroke Scale [NIHSS], Scandinavian Stroke Scale [SSS], Barthel Index, and Rankin scale) at days 1, 2, 5, 30, and 90. Furthermore, we performed volumetric analysis of infarct volumes on days 1, 2, and 5 as shown in PWI, DWI, and T2-weighted imaging.Twenty-four patients received rtPA within a mean time interval after symptom onset of 3.27 hours and stroke MRI of 3.43 hours. Vessel occlusion was present in 20 of 24 patients; 11 vessels recanalized (group 1), and 9 did not (group 2). The baseline PWI lesion volume was significantly larger (P=0.008) than outcome lesion size in group 1, whereas baseline DWI lesion volume was significantly smaller (P=0.008) than final infarct size in group 2. Intergroup outcome differed significantly for all scores at days 30 and 90 (all P<0.01). Intragroup differences were significant in group 1 for change in SSS and NIHSS between day 1 and day 30 (P=0.003) and for SSS only between day 1 and day 90 (P=0.004).Stroke MRI provides comprehensive prognostically relevant information regarding the brain in hyperacute stroke. Stroke MRI may be used as a single imaging tool in acute stroke to identify and monitor candidates for thrombolysis. It is proposed that stroke MRI is safe, reliable, and cost effective; however, our data do not prove this assumption. Early recanalization achieved by thrombolysis can save tissue at risk if present and may result in significantly smaller infarcts and a significantly better outcome.
最长约 10秒,即可获得该文献文件

科研通智能强力驱动
Strongly Powered by AbleSci AI
更新
PDF的下载单位、IP信息已删除 (2025-6-4)

科研通是完全免费的文献互助平台,具备全网最快的应助速度,最高的求助完成率。 对每一个文献求助,科研通都将尽心尽力,给求助人一个满意的交代。
实时播报
研友_LBRPOL完成签到,获得积分10
1秒前
gao完成签到 ,获得积分10
2秒前
zq发布了新的文献求助10
2秒前
韭黄发布了新的文献求助10
3秒前
她的城完成签到,获得积分0
3秒前
单薄的钢笔完成签到,获得积分10
5秒前
568923完成签到,获得积分10
7秒前
Grace159完成签到 ,获得积分10
10秒前
咖啡博士发布了新的文献求助10
12秒前
彦祖i学术完成签到,获得积分10
14秒前
zq完成签到,获得积分20
15秒前
HY完成签到,获得积分10
16秒前
不再挨训完成签到 ,获得积分10
17秒前
学术乞丐完成签到,获得积分20
19秒前
咖啡博士完成签到,获得积分10
20秒前
韭黄发布了新的文献求助10
21秒前
Singularity完成签到,获得积分0
23秒前
JamesPei应助zq采纳,获得10
24秒前
所所应助韭黄采纳,获得10
28秒前
江霭完成签到,获得积分10
31秒前
鲤鱼青槐完成签到,获得积分10
40秒前
量子星尘发布了新的文献求助10
41秒前
44秒前
缥缈的冰旋完成签到,获得积分10
44秒前
50秒前
51秒前
ailemonmint完成签到 ,获得积分10
51秒前
52秒前
玉ER完成签到,获得积分10
53秒前
54秒前
四十四次日落完成签到 ,获得积分10
54秒前
科研通AI2S应助羊二呆采纳,获得10
54秒前
英吉利25发布了新的文献求助10
56秒前
57秒前
水晶茶杯发布了新的文献求助10
58秒前
欢欢完成签到,获得积分10
59秒前
茯苓完成签到 ,获得积分10
1分钟前
小鱼发布了新的文献求助10
1分钟前
香香丿完成签到 ,获得积分10
1分钟前
1分钟前
高分求助中
【提示信息,请勿应助】关于scihub 10000
Les Mantodea de Guyane: Insecta, Polyneoptera [The Mantids of French Guiana] 3000
徐淮辽南地区新元古代叠层石及生物地层 3000
The Mother of All Tableaux: Order, Equivalence, and Geometry in the Large-scale Structure of Optimality Theory 3000
Handbook of Industrial Diamonds.Vol2 1100
Global Eyelash Assessment scale (GEA) 1000
Picture Books with Same-sex Parented Families: Unintentional Censorship 550
热门求助领域 (近24小时)
化学 材料科学 医学 生物 工程类 有机化学 生物化学 物理 内科学 纳米技术 计算机科学 化学工程 复合材料 遗传学 基因 物理化学 催化作用 冶金 细胞生物学 免疫学
热门帖子
关注 科研通微信公众号,转发送积分 4038112
求助须知:如何正确求助?哪些是违规求助? 3575788
关于积分的说明 11373801
捐赠科研通 3305604
什么是DOI,文献DOI怎么找? 1819255
邀请新用户注册赠送积分活动 892655
科研通“疑难数据库(出版商)”最低求助积分说明 815022