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| The cerebral perfusion mechanism study of dynamic susceptibility contrasted magnetic resonance imaging for progressive stroke |
| QIAN Jing-jing, WU Qing-jie, LU Zhong-lie, ZHANG Xiao-ling, LIU Hu, MA Qin-wei |
| The Second Hospital of Jiaxing, Jiaxing Zhejiang 314000, China |
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Abstract Objective: To explore progressive stroke mechanism of early cerebral infarction by using dynamic susceptibility contrasted magnetic resonance imaging, to obtain and analyze the progressive and non-progressive patients’ hemodynamic parameters, provide valuable theory for improving clinical therapy and prognosis. Methods: Sixty patients with acute cerebral stroke during 24 h underwent dynamic susceptibility contrasted magnetic resonance imaging and were given NISS grading score on admission. The patients with exacerbation during 72 h as well as the NISS score adds 2 points or more were classified into the progressive group(24 cases), others were classified into the non-progressive group(36 cases). The diagram of rCBV, rCBF, MTT and TTP were calculated by post-processing of Functool software. The value of the CBF, CBV, MTT and TTP between the infarct center and surrounding tissue were compared and analyzed by two independent sample t test(SPSS 17.0 software). Using contralateral hemisphere as a reference area of interest(ROI), the relative value of the perfusion parameters between affected side and contralateral side was calculated. Results: In both of the progressive and non-progressive group, CBF and CBV values of infarction center were declined, MTT and TTP values were increased, which implied hypoperfusion. Severe hypoperfusion in two groups: brain infarction with the rCBF less than 0.5, MTT increasing more than 1.63, TI more than 4 s. This situation may be the related risk factors that the ischemic brain tissue develops into infarction. The perfusion parameters of relatively normal regional around the lesions can be divided into four types: Type 1, hypoperfusion, markedly increased MTT, the regional decreased CBV, dramatic declined regional CBF; Type 2, the collateral circulation formation, increased MTT, increased or normal regional CBV; Type 3, blood reperfusion, decreased or normal MTT, increased regional CBV, normal or slightly increased regional CBF; Type 4, excessive perfusion information, increased significantly regional CBV and CBF. The types of the progressive group is mainly hypoperfusion, but the non-progressive group includes the four kinds of above. It was convenient for effective master thrombolysis time window and individualized treatment plan to analyze above microcirculation perfusion type in the relative normal around the lesion area. Conclusion: Dynamic susceptibility contrasted magnetic resonance imaging(DSC-MRI) can provide ischemic penum’s brametabolism and superfine morphological information in the early stage of super acute cerebral infarction and guide the clinical treatment, so as to prevent or reduce the occurrence of cerebral infarction finally.
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Received: 25 December 2014
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2015, Vol. 26 
