Regional Cerebral Blood Volume Ratio on Perfusion MRI on the Growth of Infarct Size in Acute Ischemic Stroke

We hypothesized that the relative regional cerebral blood volume (rCBV) ratio could help predict the risk of infarct growth on follow-up magnetic resonance imaging (MRI) in patients with diffusion perfusion mismatch (DPM) on the time-to-peak (TTP) map. We recruited 60 patients with acute middle cerebral arterial (MCA) infarction who had been evaluated by perfusion MRI within 24 h of initial ischemic events, and assessed the predictive role of the rCBV ratio on infarct growth in patients with DPM. Among 60 patients with acute MCA ischemic stroke, 41 (68.3%) patients had DPM on the initial MRI. Follow-up MRI revealed ischemic lesion enlargement in 19 (31.7%) of these 41 patients. The presence of DPM had no effect on the rate of lesion enlargement. Patients with ischemic lesion growth in follow-up images had a significantly lower rCBV ratio than patients without (0.81 +/- 0.22 vs. 1.08 +/- 0.20, p < 0.01). In this study, the decreased rCBV ratio on perfusion MRI has a predictive value for the growth of ischemic lesions after acute ischemic stroke with DPM on the TTP map. Copyright (C) 2009 S. Karger AG, Basel