Utility of Early Post-treatment Single-Photon Emission Computed Tomography Imaging to Predict Outcome in Stroke Patients Treated with Intravenous Tissue Plasminogen Activator

Abumiya, Takeo; Katoh, Masahito; Moriwaki, Takuya; Yoshino, Masami; Aoki, Takeshi; Imamura, Hiroyuki; Aida, Toshimitsu; Scichinohe, Hideo; Nakayama, Naoki; Kazumata, Ken; Houkin, Kiyohiro

Utility of Early Post-treatment Single-Photon Emission Computed Tomography Imaging to Predict Outcome in Stroke Patients Treated with Intravenous Tissue Plasminogen Activator

Abumiya, Takeo; Katoh, Masahito; Moriwaki, Takuya et al.

Journal of Stroke & Cerebrovascular Diseases, 2014, 23(5), 896-901

Permalink : https://hdl.handle.net/2115/56601

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アクセス権	open access
URI	https://hdl.handle.net/2115/56601
タイトル	Utility of Early Post-treatment Single-Photon Emission Computed Tomography Imaging to Predict Outcome in Stroke Patients Treated with Intravenous Tissue Plasminogen Activator
著者	Abumiya, Takeo ; Katoh, Masahito ; Moriwaki, Takuya ; Yoshino, Masami ; Aoki, Takeshi ; Imamura, Hiroyuki ; Aida, Toshimitsu ; Scichinohe, Hideo ; Nakayama, Naoki ; Kazumata, Ken ; Houkin, Kiyohiro
e-Rad_Researcher 80270726 著者名 Abumiya, Takeo
著者名 Katoh, Masahito
著者名 Moriwaki, Takuya
著者名 Yoshino, Masami
著者名 Aoki, Takeshi
著者名 Imamura, Hiroyuki
e-Rad_Researcher 60125276 著者名 Aida, Toshimitsu
著者名 Scichinohe, Hideo
e-Rad_Researcher 40421961 著者名 Nakayama, Naoki
著者名 Kazumata, Ken
e-Rad_Researcher 90229146 著者名 Houkin, Kiyohiro
言語	英語
キーワード	Acute ischemic stroke
	tPA
	SPECT
	hypoperfusion
	hyperperfusion
発行日	2014-05
出版者	Elsevier
収録物名	Journal of Stroke & Cerebrovascular Diseases
巻(号)	23(5)
ページ	896-901
抄録	It is important to predict the outcome of tissue plasminogen activator (tPA)-treated patients early after the treatment for considering the post-tPA treatment option. We assessed cerebral blood flow (CBF) of tPA-treated patients with single-photon emission computed tomography (SPECT) 1 hour after tPA infusion to predict the patient outcome. Technetium-99m-hexamethylpropyleneamine oxime SPECT was performed in 35 consecutive tPA-treated patients. Asymmetry index, a contralateral-to-ipsilateral ratio of CBF, was calculated to analyze CBF quantitatively. Hypoperfusion or hyperperfusion was defined as a decrease of 25% or more or a increase of 25% or more in asymmetry index, respectively. Of all 35 patients, 23 had only hypoperfusion, 8 had both hypoperfusion and hyperperfusion, 2 had only hyperperfusion, and 2 had no perfusion abnormality. When evaluating the association between hypoperfusion and outcome, hypoperfusion volumes were significantly correlated with the modified Rankin Scale at 3 months (r = .634, P < .001). Hyperperfusion was observed in 10 patients (28.6%) and they showed a marked National Institutes of Health Stroke Scale score improvement in the first 24-hour period, which were significantly greater than those of 25 patients without hyperperfusion (P = .033). Eight patients (22.9%) with intracerebral hemorrhage (ICH) were all asymptomatic. Most ICHs were located in hypoperfusion areas, and no ICH was related to hyperperfusion. The results of the present study demonstrated that hypoperfusion volume was associated with poor outcome, whereas the presence of hyperperfusion seemed to be predictive of symptom improvement but not of development of ICH. Taken together, early post-treatment SPECT imaging seems to be a useful biomarker of outcome in tPA-treated patients.
資源タイプ	学術雑誌論文
出版タイプ	Accepted Manuscript
PISSN	1052-3057
NCID	AA10780852
関連情報	PMID 24045082
関連情報 (isVersionOf)	出版社版DOI https://doi.org/10.1016/j.jstrokecerebrovasdis.2013.07.028