Evolution of lesion volume in acute stroke treated by intravenous t-PA

• Published in: Journal of magnetic resonance imaging Vol. 22; no. 1; pp. 23 - 28
• Main Authors: Pialat, Jean-Baptiste, Wiart, Marlene, Nighoghossian, Norbert, Adeleine, Patrice, Derex, Laurent, Hermier, Marc, Froment, Jean-Claude, Berthezene, Yves
• Format: Journal Article
• Language: English
• Published: Hoboken Wiley Subscription Services, Inc., A Wiley Company 01.07.2005; Wiley-Blackwell
• Subjects: brain; Brain - pathology; Diffusion Magnetic Resonance Imaging; Humans; infarction; Life Sciences; magnetic resonance; Other; Reproducibility of Results; stroke; Stroke - drug therapy; Stroke - pathology; thrombolysis; Tissue Plasminogen Activator - therapeutic use
• ISSN: 1053-1807; 1522-2586
• DOI: 10.1002/jmri.20363

Purpose To determine the evolution of the ischemic lesion volumes in a population treated with tissue plasminogen activator (t‐PA), MRIs were performed before treatment and 24 hours later; final infarct size was evaluated 60 days later. Materials and Methods A total of 42 patients with hemispheric stroke were recruited for a thrombolytic study. Intravenous t‐PA was given after MRI within the first seven hours after stroke onset. Volumes were evaluated on day 0 and day 1 with diffusion‐weighted imaging (DWI), on day 60 with T2‐weighted imaging (T2WI), and recanalization was assessed based on day 1 MR angiography (MRA). Results Lesion volume increased between day 0 and day 1, and decreased between day 1 and day 60. It was lower in the group of patients with recanalization on day 1 MRA. Conclusion Volume analysis emphasizes the effectiveness of recanalization as a predictive factor for better outcome, based on final infarct size. The decrease in lesion volumes between day 1 and day 60 suggests that other factors leads to overestimation of day 1 abnormal diffusion volume. This could explain the delayed partial reversibility of the DWI abnormality. J. Magn. Reson. Imaging 2005;22:23–28. © 2005 Wiley‐Liss, Inc.