Contralateral Hemispheric Cerebral Blood Flow Measured With Arterial Spin Labeling Can Predict Outcome in Acute Stroke
| Autor: | Tudor G Jovin, Maarten G Lansberg, Michael P. Marks, Soren Christensen, Gregory W. Albers, Bart P Keogh, Jia Guo, Tie Liang, Michael Mlynash, Stephanie Kemp, Emma Adair, Irina Eyngorn, Huy M. Do, Greg Zaharchuk, Thoralf Thamm, Jarrett Rosenberg, Hui J Chen |
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| Rok vydání: | 2019 |
| Předmět: |
Male
medicine.medical_specialty Neuroimaging Perfusion scanning Article Brain Ischemia 030218 nuclear medicine & medical imaging 03 medical and health sciences 0302 clinical medicine Modified Rankin Scale Interquartile range Internal medicine medicine Humans cardiovascular diseases Prospective Studies Prospective cohort study Stroke Aged Advanced and Specialized Nursing medicine.diagnostic_test business.industry Brain Magnetic resonance imaging Middle Aged medicine.disease Magnetic Resonance Imaging Clinical trial Treatment Outcome Cerebral blood flow Cerebrovascular Circulation Cardiology Female Neurology (clinical) Cardiology and Cardiovascular Medicine business 030217 neurology & neurosurgery |
| Zdroj: | Stroke |
| ISSN: | 1524-4628 0039-2499 |
| DOI: | 10.1161/strokeaha.119.026499 |
| Popis: | Background and Purpose— Imaging is frequently used to select acute stroke patients for intra-arterial therapy. Quantitative cerebral blood flow can be measured noninvasively with arterial spin labeling magnetic resonance imaging. Cerebral blood flow levels in the contralateral (unaffected) hemisphere may affect capacity for collateral flow and patient outcome. The goal of this study was to determine whether higher contralateral cerebral blood flow (cCBF) in acute stroke identifies patients with better 90-day functional outcome. Methods— Patients were part of the prospective, multicenter iCAS study (Imaging Collaterals in Acute Stroke) between 2013 and 2017. Consecutive patients were enrolled after being diagnosed with anterior circulation acute ischemic stroke. Inclusion criteria were ischemic anterior circulation stroke, baseline National Institutes of Health Stroke Scale score ≥1, prestroke modified Rankin Scale score ≤2, onset-to-imaging time Results— Seventy-seven patients (41 women) met the inclusion criteria with median (interquartile range) age of 66 (55–76) yrs, onset-to-imaging time of 4.8 (3.6–7.7) hours, and baseline National Institutes of Health Stroke Scale score of 13 (9–20). Median cCBF was 38.9 (31.2–44.5) mL per 100 g/min. Higher cCBF predicted good outcome at day 90 (odds ratio, 4.6 [95% CI, 1.4–14.7]; P =0.01), after controlling for baseline National Institutes of Health Stroke Scale, diffusion-weighted imaging lesion volume, and intra-arterial therapy. Conclusions— Higher quantitative cCBF at baseline is a significant predictor of good neurological outcome at day 90. cCBF levels may inform decisions regarding stroke triage, treatment of acute stroke, and general outcome prognosis. Clinical Trial Registration— URL: https://www.clinicaltrials.gov . Unique identifier: NCT02225730. |
| Databáze: | OpenAIRE |
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