Acute stroke syndromes with isolated hypoperfusion on MRI

• Verfasst von: Alonso, Angelika [VerfasserIn]
• Verfasst von: Szabo, Kristina [VerfasserIn]
• Verfasst von: Wolf, Marc [VerfasserIn]
• Verfasst von: Ebert, Anne [VerfasserIn]
• Verfasst von: Griebe, Martin [VerfasserIn]
• Verfasst von: Hennerici, Michael G. [VerfasserIn]
• Verfasst von: Gass, Achim [VerfasserIn]
• Titel: Acute stroke syndromes with isolated hypoperfusion on MRI
• Titelzusatz: a clinical and MRI study
• Verf.angabe: Angelika Alonso, Kristina Szabo, Marc E. Wolf, Anne D. Ebert, Martin Griebe, Michael G. Hennerici, Achim Gass
• E-Jahr: 2016
• Jahr: January 7, 2016
• Umfang: 6 S.
• Fussnoten: Gesehen am 09.01.2019
• Titel Quelle: Enthalten in: European neurology
• Ort Quelle: Basel : Karger, 1968
• Jahr Quelle: 2016
• Band/Heft Quelle: 75(2016), 1-2, Seite 27-32
• ISSN Quelle: 1421-9913
• DOI: doi:10.1159/000443305
• Datenträger: Online-Ressource
• Sprache: eng
• K10plus-PPN: 1586052225

Abstract

Background: Acute stroke syndromes with negative diffusion-weighted imaging (DWI) but extensive perfusion deficits are rare and constitute a diagnostic challenge due to different operational definitions of penumbral hypoperfusion in acute stroke patients based on MRI criteria. Methods: MR profiles of 19 patients presenting with acute stroke syndromes with negative DWI in the presence of an extensive area of hypoperfusion on time-to-peak (TTP) maps of dynamic susceptibility contrast perfusion-weighted imaging (PWI) were analysed. DWI and PWI lesions were quantified and interpreted with regard to the clinical course. Results: Despite the large area of abnormal perfusion on TTP maps, the clinical course was benign (median National Institute of Health Stroke Scale 2 at admission, 0 at discharge). The volume of hypoperfused tissue was significantly smaller on postprocessed TTP maps with a TTP delay of >4 s than on unprocessed TTP maps with manual contrast adjustment. Semiquantitatively assessed TTP lesion volume was associated with the presence of DWI lesions on follow-up. Conclusion: TTP maps are highly sensitive to demonstrate even small-scale perfusion abnormalities. The additional information from TTP delay thresholds indicates critically reduced perfusion and appears to be a good prognostic indicator in combination with MR angiography and symptomatology.