Elijovich Lucas, Doss Vinodh T, Theessen Heike, Khan Maheen, Arthur Adam S
Semmes-Murphey Clinic, Memphis, Tennessee, USA.
BMJ Case Rep. 2013 Aug 20;2013:bcr2013010756. doi: 10.1136/bcr-2013-010756.
Parenchymal blood volume (PBV) mapping with flat panel detectors may provide real-time estimates of tissue perfusion during endovascular ischemic stroke procedures. We present two cases of acute middle cerebral artery (MCA) occlusion to demonstrate how PBV may: (1) be used in acute stroke; (2) influence intraprocedural decision-making; and (3) potentially serve as a predicator of clinical outcome. Both cases were successfully recanalized with endovascular embolectomy. Intraprocedural PBV maps were obtained immediately before and after recanalization. Pre-intervention reductions in PBV were seen throughout the MCA territory in both cases, with significant improvement in PBV in one case with good radiographic and clinical outcome and a lack of improvement in PBV in the second case with a large infarct volume. PBV deficit normalization may occur with recanalization of the parent artery and probably represents successful reperfusion. Baseline PBV maps should therefore be interpreted with caution and not interpreted to represent irreversible core infarct.
使用平板探测器进行实质血容量（PBV）映射可在血管内缺血性中风手术期间提供组织灌注的实时估计。我们展示了两例急性大脑中动脉（MCA）闭塞病例，以说明PBV如何：（1）用于急性中风；（2）影响术中决策；（3）潜在地作为临床结果的预测指标。两例均通过血管内取栓术成功再通。在再通前后立即获取术中PBV图。两例患者在整个MCA区域术前均出现PBV降低，其中一例患者PBV有显著改善，影像学和临床结果良好，而另一例梗死体积较大的患者PBV没有改善。随着供血动脉再通，PBV缺损可能会恢复正常，这可能代表成功再灌注。因此，对基线PBV图的解读应谨慎，不能将其解读为代表不可逆的核心梗死。
