Prediction of acute embolic stroke outcome after local intraarterial thrombolysis: Value of pretreatment and posttreatment Tc-99m-ethyl cysteinate dimer single photon emission computed tomography

Citation
K. Ogasawara et al., Prediction of acute embolic stroke outcome after local intraarterial thrombolysis: Value of pretreatment and posttreatment Tc-99m-ethyl cysteinate dimer single photon emission computed tomography, J CEREBR B, 20(11), 2000, pp. 1579-1586
Citations number
39
Language
INGLESE
art.tipo
Article
Categorie Soggetti
Neurosciences & Behavoir
Journal title
JOURNAL OF CEREBRAL BLOOD FLOW AND METABOLISM
ISSN journal
0271-678X → ACNP
Volume
20
Issue
11
Year of publication
2000
Pages
1579 - 1586
Database
ISI
SICI code
0271-678X(200011)20:11<1579:POAESO>2.0.ZU;2-W
Abstract
The aim of this study was to investigate the efficacy of pre- and posttreat ment Tc-99m-ethyl cysteinate dimer (Tc-99m-ECD) single photon emission comp uted tomography (SPECT) for predicting the ischemic outcome of embolic midd le cerebral artery occlusion after treatment with local intraarterial throm bolysis. The authors examined 28 patients with a moderately ischemic area ( ratio of affected regional activity to cerebellar activity (A/C ratio) of 0 .4 to 0.7) determined using pretreatment SPECT, and with complete recanaliz ation within 6 hours. Posttreatment dynamic and static SPECT studies were p erformed immediately after thrombolysis. The extent of the affected area ou tlined on pretreatment SPECT was used for the posttreatment SPECT images, a nd AIC ratios were calculated. The relative retention ratio of Tc-99m-ECD i n the affected area was also analyzed using posttreatment dynamic SPECT. Fo ur-teen patients either without infarction or with small subcortical and ba sal ganglial infarction, 11 patients with medium or large cortical infarcti on, and 3 patients with hemorrhage were identified by follow-up computed to mography. Ischemic outcome correlated with the relative retention ratio of Tc-99m-ECD more closely than either the pre- or posttreatment A/C ratios. I n particular, a threshold value for the development of hemorrhage was disti nct only in the relative retention ratio of Tc-99m-ECD. Pretreatment Tc-99m -ECD SPECT did not always predict the occurrence of hemorrhagic transformat ion, whereas dynamic Tc-99m-ECD SPECT performed immediately after thromboly sis allowed clear identification of patients at risk for hemorrhagic transf ormation.