급성 허혈성 뇌졸중 환자에서 perfusion CT의 임상적 유용성

Abstract

Background: The goal of this study was to evaluate the utility of perfusion-weighted CT in predicting clinicaloutcome in patients with acute middle cerebral artery territory infarction.

Methods: Twenty-nine patients withacute middle cerebral artery stroke had brain noncontrast CT and perfusion-weighted CT imaging within 6 hoursof stroke onset. They were divided into following four groups according to the difference in hypoperfused lesionbetween cerebral blood volume (CBV) and cerebral blood flow (CBF), and the use of thrombolytic agent. group 1;the size of the hypoperfused lesion in CBV < that in CBF with the use of thrombolytic agent, group 2; the size ofthe hypoperfused lesion in CBV < that in CBF without the use of thrombolytic agent, group 3; the size of thehypoperfused lesion in CBV = that in CBF with the use of thrombolytic agent, group 4; the size of the hypoper-fused lesion in CBV = that in CBF without the use of thrombolytic agent. Degree of clinical improvement wasmeasured by the difference of NIHSS score between admission and discharge day.

Results: Of 29 patients, 13patients were included in group 1, eight in group 2, two in group 3, and six in group 4. Degree of clinical improve-ment was significantly different between the four groups (p<0.05); Group 1 had a higher degree of clinicalimprovement.

Conclusion: Perfusion CT may provide valuable information in predicting clinical outcome afterthrombolysis and help us to select good candidates for thrombolytic therapy.