Beaulieu C, de Crespigny A, Tong D C, Moseley M E, Albers G W, Marks M P
Department of Radiology, Stanford University, CA 94305-5105, USA.
Ann Neurol. 1999 Oct;46(4):568-78. doi: 10.1002/1531-8249(199910)46:4<568::aid-ana4>3.0.co;2-r.
A prospective longitudinal diffusion-weighted and perfusion-weighted magnetic resonance imaging (DWI/PWI) study of stroke patients (n = 21) at five distinct time points was performed to evaluate lesion evolution and to assess whether DWI and PWI can accurately and objectively demonstrate the degree of ischemia-induced deficits within hours after stroke onset. Patients were scanned first within 7 hours of symptom onset and then subsequently at 3 to 6 hours, 24 to 36 hours, 5 to 7 days, and 30 days after the initial scan. Lesion evolution was dynamic during the first month after stroke. Most patients (18 of 19, 95%) showed increased lesion volume over the first week and then decreased at 1 month relative to 1 week (12 of 14, 86%). Overall, lesion growth appeared to depend on the degree of mismatch between diffusion and perfusion at the initial scan. Abnormal volumes on the acute DWI and PWI (<7 hours) correlated well with initial National Institutes of Health (NIH) stroke scale scores, outcome NIH stroke scale scores, and final lesion volume. DWI and PWI can provide an early measure of metabolic and hemodynamic insufficiency, and thus can improve our understanding of the evolution and outcome after acute ischemic stroke.
对21名中风患者进行了一项前瞻性纵向扩散加权和灌注加权磁共振成像（DWI/PWI）研究，在五个不同时间点进行扫描，以评估病变演变，并评估DWI和PWI是否能在中风发作后数小时内准确、客观地显示缺血性损伤的程度。患者在症状发作后7小时内首次扫描，然后在初次扫描后的3至6小时、24至36小时、5至7天和30天进行后续扫描。中风后的第一个月内，病变演变是动态的。大多数患者（19例中的18例，95%）在第一周内病变体积增加，然后在1个月时相对于1周有所减小（14例中的12例，86%）。总体而言，病变生长似乎取决于初次扫描时扩散与灌注的不匹配程度。急性DWI和PWI（<7小时）上的异常体积与初始美国国立卫生研究院（NIH）中风量表评分、结局NIH中风量表评分以及最终病变体积密切相关。DWI和PWI可以提供代谢和血流动力学不足的早期测量方法，从而有助于我们更好地理解急性缺血性中风后的演变和结局。
