급성뇌경색의 동맥내 재혈류화 치료에서 유용한 인자인 상대적 대뇌혈류량에 대한 연구

초록

PURPOSE : Relative cerebral blood volume (rCBV) calculated by comparing the values in the ischemic lesion and the unaffected contralateral region represents the extent of collateral circulation and vasodilation in perfusion-weighted magnetic resonance image (PWI). We sought to determine whether rCBV was associated with recanalization, complication, and clinical outcomes in intraarterial (IA) revascularization. MATERIALS AND METHODS : We retrospectively reviewed the middle cerebral artery (MCA) infarction patients within 6 hours of symptoms onset who were tried IA revascularization between February 2009 and April 2013. Statistical analysis were performed to determine whether rCBV was correlated to the NIHSS, recanalization outcome (TIMI grade), parenchymal hemorrhage, remarkable progression of infarction or cerebral swelling, and modified Rankin scale (mRS) at 30 days. RESULTS : A total of 23 patients with a mean age of 62 years and mean National Institutes of Health Stroke Scale scores of 13 were studied. A reduced rCBV was associated with lower recanalization rate (p < 0.001), higher risk of parenchymal hemorrhage (p = 0.007), and poorer clinical outcomes (p=0.009). Initial neurological status or progression of infarction size or cerebral swelling was not associated with rCBV statistically. CONCLUSION : Our study suggests that patients with higher rCBV are more likely to recanalize after IA revascularization in acute MCA infarction. A reduced rCBV increases the risk of parenchymal hemorrhage, and associated with the poorer clinical outcome. In conclusion, rCBV can be a useful parameter in determining potentially suitable candidates for acute ischemic stroke interventions.