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Influence of the site of arterial occlusion on multiple baseline hemodynamic MRI parameters and post-thrombolytic recanalization in acute stroke

  • Diagnostic Neuroradiology
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Abstract

In this prospective MRI study, we evaluated the impact of the site of occlusion on multiple baseline perfusion parameters and subsequent recanalization in 49 stroke patients who were given intravenous tissue plasminogen activator (tPA). Pretreatment magnetic resonance angiography (MRA) revealed an arterial occlusion in 47 patients: (1) internal carotid artery (ICA) + M1 middle cerebral artery (MCA) occlusion (n=12); (2) M1 MCA occlusion (n=19); (3) M2 MCA, distal branches of the MCA and anterior cerebral artery (ACA) occlusion (n=16). Patients with ICA occlusion had significantly larger DWI, PWI and mismatch lesion volume on pretreatment MRI compared to patients with other sites of occlusion. The differences in cerebral blood flow (CBF) and peak height were significantly higher in patients with ICA occlusion compared to patients with other sites of occlusion (P=0.03 and P=0.04, respectively). Day 1 MRA showed recanalization in 28 patients (60%). The rate of recanalization was significantly different depending on the site of occlusion: 33% in ICA + M1 MCA occlusion, 63% in M1 MCA occlusion and 81% in either M2 MCA, distal branches of the MCA or ACA occlusion (P=0.002). Our data suggest that CBF and peak height are the most relevant MRI parameters to assess the severity of hemodynamic impairment in regard to the site of occlusion.

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Acknowledgements

The authors thank Michèle Canova for her help in collecting and processing the data.

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Authors and Affiliations

  1. Service d’Urgences NeuroVasculaires, Hôpital Neurologique, 59 Boulevard Pinel, 69003, Lyon, France

    L. Derex, P. Trouillas & N. Nighoghossian

  2. Service de Biostatistique, Hospices Civils de Lyon, Lyon, France

    P. Adeleine

  3. Service de Neuroradiologie, Hôpital Neurologique, Lyon, France

    M. Hermier & J. C. Froment

  4. CREATIS, UMR CNRS 5515, U 630 INSERM, Lyon, France

    L. Derex, M. Hermier, J. B. Pialat, M. Wiart, Y. Berthezène, J. C. Froment & N. Nighoghossian

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  1. L. Derex
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  2. M. Hermier
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  3. P. Adeleine
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  4. J. B. Pialat
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  5. M. Wiart
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  6. Y. Berthezène
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  7. J. C. Froment
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  8. P. Trouillas
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  9. N. Nighoghossian
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Correspondence to L. Derex.

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Derex, L., Hermier, M., Adeleine, P. et al. Influence of the site of arterial occlusion on multiple baseline hemodynamic MRI parameters and post-thrombolytic recanalization in acute stroke. Neuroradiology 46, 883–887 (2004). https://doi.org/10.1007/s00234-004-1279-y

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  • DOI: https://doi.org/10.1007/s00234-004-1279-y

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