Analysis of the value of PWI-DWI in evaluating the ischemic penumbra in guiding intravenous thrombolysis in hyper-acute cerebral infarction
ZHANG Chunhai
LIU Yang
YAN Kun
GU Dunxing
LI Shaoxuan
Abstract：Objective To analyze the guidance value of perfusion weighted imaging-diffusion weighted imaging(PWI-DWI)mismatch in evaluating ischemic penumbra(IP)for intravenous thrombolysis in acute cerebral infarction(ACI)beyond time win-dow.Methods A retrospective analysis was performed on the clinical data of 86 patients with ACI beyond time window who were assessed by PWI-DWI mismatch technique in the hospital.According to vascular recanalization after intravenous thromboly-sis,patients were divided into recanalization group(50 cases)and non-recanalization group(36 cases).The cerebral blood vol-ume(CBV),cerebral blood flow(CBF)and mean transit time(MTT)in IP were compared between the two groups.Taking healthy side as the control,relative values of the three parameters(rCBV,rCBF,rMTT)were calculated.The predictive value of different parameters for vascular recanalization in patients with ACI beyond time window after intravenous thrombolysis was analyzed by ROC curves.Results After thrombolysis,CBV,CBF,rCBV and rCBF of IP in non-recanalization group were lower than those in recanalization group,while,MTT and rMTT were higher than those in recanalization group(P<0.05).The re-sults of ROC curves analysis showed that MTT(AUC=0.639),CBV(AUC=0.689),CBF(AUC=0.689),rMTT(AUC=0.669),rCBV(AUC=0.757)and rCBF(AUC=0.771)were all of good predictive value for vascular recanalization,and predictive value of combined detection was higher(AUC=0.777,P<0.05).Conclusion PWI-DWI mismatch in evaluating IP can effectively guide intravenous thrombolysis in patients with ACI beyond time window,and the relevant parameters have good predictive value for vascular revascularization after intravenous thrombolysis.
Keywords：Acute cerebral infarction beyond time windowIschemic penumbraIntravenous thrombolysisMagnetic reso-nance imaging
Publication Date：2025-02-28
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：5( 6-10 )