RESUMO
Ultrasonic perfusion imaging predicts size and localization of acute stroke. It is unclear whether irreversibly damaged tissue can be differentiated from tissue at risk. Thirty-four patients (ischemic stroke <12 h) were included (Phase Inversion Harmonic Perfusion Imaging; bolus kinetic; fitted model function). Three patterns of perfusion were defined in 14 prespecified regions of interest (ROI): 'normal', 'hypoperfusion', and 'no perfusion'. Clinical status was assessed using the National Institutes of Health Stroke Scale (NIHSS) (at baseline and at days 2 to 4). Cranial Computed Tomography (CCT) (days 2 to 4) displayed final infarction. The pattern 'hypoperfusion' (ROIs presumably representing tissue at risk) was tested twofold: (i) Functional impairment by correlating their number with baseline NIHSS. (ii) Viability by correlating their recruitment rate to infarction with clinical course (DeltaNIHSS days 2 to 4). In addition, various predictive values were assessed. Twenty-seven patients were eligible for analysis. The sum of ROIs with 'no perfusion' and 'hypoperfusion' correlated highest with baseline NIHSS (rho=0.78, P<0.001). Recruitment of hypoperfused ROIs to infarction highly correlated with clinical course (rho=0.79, P<0.001). Clinical course dichotomized the patients into subgroups A ('stable', DeltaNIHSS>or=-3) and B ('improved', DeltaNIHSSAssuntos
Isquemia Encefálica/patologia
, Perfusão
, Acidente Vascular Cerebral/diagnóstico por imagem
, Ultrassonografia/métodos
, Idoso
, Idoso de 80 Anos ou mais
, Meios de Contraste
, Feminino
, Humanos
, Masculino
, Pessoa de Meia-Idade
, Artéria Cerebral Média/diagnóstico por imagem
, Artéria Cerebral Média/patologia
, Sensibilidade e Especificidade
, Acidente Vascular Cerebral/diagnóstico
, Acidente Vascular Cerebral/patologia
, Tomografia Computadorizada por Raios X
, Ultrassonografia/normas