Dynamic changes and clinical value of blood perfusion in perfusion weighted image-diffusion weighted image mismatched regions after stroke / 中华神经科杂志

ABSTRACT

Objective To investigate the changes and the mechanism of blood perfusion in perfusion weighted image ( PWI)-diffusion weighted image ( DWI) mismatched regions after infarction and to assess the effect on prognosis .Methods We assessed 84 patients with acute cerebral infarction within 72 hours of onset in the territory of anterior circulation , who admitted to Affiliated Drum Tower Hospital , Nanjing University Medical School between January 2009 and June 2011.All patients were imaged with 3.0 T MRI on day one.The patients were divided into mismatched group (31 patients) and matched group (53 patients) according to the basis of PWI-DWI.The two groups received the same treatment including anti-platelet, oxygen free radical scavenger and lowing cholesterol therapy .Barthel index was used to evaluate neurological deficit on day 0, day 12 and three months later.We also compared the perfusion parameters of day 0 with day 12 by PWI from mismatched group.Results On day 12, the value of relative cerebral blood flow increased by 7.37%(t=-2.076, P<0.05) and the value of relative mean transit time decreased by 11.06%(t=2.972,P<0.01) compared with that on day 0 from mismatched group.However, there was no significant difference in Activity of Daily Living scale ( ADL) score between the two groups after 12 days′treatment.After three months, the patients of mismatched group had higher ADL score (75.48 ±3.26) than that of matched group (66.23 ±3.04; t=2.079, P<0.05).Conclusion The patients of mismatched group had better neurofunction than matched group , possibly related to improvement of perfusion in mismatched area.