Author(s): CHEN Wei-Li, ZHANG Sheng, ZHANG Shun-Kai, LOU Min
Pages: 899-904
Year: 2014 Issue:  11
Journal: Chinese Journal of Stroke
Keyword:  Acute; Ischemic stroke; Hemorrhagic transformation; Tmax;
Abstract: Objective To test whether Tmax of magnetic resonance imaging (MRI) could predict cerebral parechymal hemorrhage (PH) after intravenous thrombolysis and then investigate its optimal threshold. Methods Acute ischemic stroke patients undergoing intravenous thrombolysis were retrospectively analyzed. Follow-up imaging of MRI or computed tomography (CT) within 24 hours was assessed for hemorrhagic transformation according to European Cooperative Acute Stroke Study (ECASSⅡ) system. The optimal threshold and the optimal volume of Tmax to predict PH were analyzed with receiver operating characteristic curve (ROC). The association of Tmax with PH was examined using Logistic regression. Results One hundred and twelve patients were analyzed, of whom 11 (9.8%) deveolped PH after thrombolysis. Tmax>8 s was the optimal threshold to predict PH (area under curve [AUC]=0.706, P=0.025). The volume>45 ml of hypoperfusion region (Tmax>8 s) was independently predictive of PH (P=0.014, odds ratio [OR]=13.95). There were no signiifcant differences of the Tmax>14 s volumes or the ratio of Tmax>14 s/Tmax>8 s between PH group and non-PH group (P=0.064;P=0.74). Conclusion The MR perfusion parameter of Tmax>8 s was the optimal threshold to predict PH. Hypoperfusion volume, rather than hypoperfusion intensity, was associated with PH.