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European Radiology
Published in: European Radiology 12/2017

01-12-2017 | Magnetic Resonance

Impact of perfusion lesion in corticospinal tract on response to reperfusion

Authors: Ying Zhou, Ruiting Zhang, Sheng Zhang, Shenqiang Yan, Ze Wang, Bruce C. V. Campbell, David S. Liebeskind, Min Lou

Published in: European Radiology | Issue 12/2017

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Abstract

Objectives

We aimed to examine the impact of corticospinal tract (CST) involvement in acute ischaemic stroke (AIS) patients on functional outcome and the interaction with reperfusion.

Methods

We retrospectively examined data in consecutive anterior circulation AIS patients undergoing thrombolysis. MR perfusion (time to maximum of tissue residue function, Tmax) and apparent diffusion coefficient (ADC) images were transformed into standard space and the volumes of CST involvement by Tmax > 6 s (CST-Tmax) and ADC < 620 × 10−6 mm2/s (CST-ADC) lesions were calculated. Good outcome was defined as modified Rankin scale ≤ 2 at 3 months. Reperfusion was defined as a reduction in Tmax > 6 s lesion volume of ≥70% between baseline and 24 h.

Results

82 patients were included. Binary logistic regression revealed that both CST-Tmax and CST-ADC volume at baseline were significantly associated with poor outcome (p < 0.05). The 24-h CST-ADC volume was correlated with baseline CST-ADC volume in patients with reperfusion (r = 0.79, p < 0.001) and baseline CST-Tmax volume in patients without reperfusion (r = 0.67, p < 0.001). In patients with CST-Tmax volume > 0 mL and CST-ADC volume < 3 mL, the rate of good outcome was higher in patients with reperfusion than those without (70.4% vs 38.1%, p = 0.04).

Conclusions

The use of CST-Tmax in combination with CST-ADC provides prognostic information in patients considered for reperfusion therapies.

Key Points

• Examine the impact of corticospinal tract involvement in acute ischaemic stroke patients.
• Spatially registered Tmax images can identify corticospinal tract hypoperfusion injury.
• Corticospinal tract salvage through reperfusion is associated with improved outcome.
Appendix
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Metadata
Title
Impact of perfusion lesion in corticospinal tract on response to reperfusion
Authors
Ying Zhou
Ruiting Zhang
Sheng Zhang
Shenqiang Yan
Ze Wang
Bruce C. V. Campbell
David S. Liebeskind
Min Lou
Publication date
01-12-2017
Publisher
Springer Berlin Heidelberg
Published in
European Radiology / Issue 12/2017
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-017-4868-y

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