Lee Gha-Hyun, Kim Jae Seung, Oh Seung Jun, Kang Dong-Wha, Kim Jong S, Kwon Sun U
Department of Neurology, Pusan National University Hospital, Pusan National University School of Medicine and Medical Research Institute, Busan, South Korea.
Department of Nuclear Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea.
J Neuroimaging. 2015 Jul-Aug;25(4):652-5. doi: 10.1111/jon.12180. Epub 2014 Oct 14.
(18) F-fluoromisonidazole (FMISO) positron emission tomography (PET) is used to image metabolically compromised but viable hypoxic tissue. We hypothesized that FMISO PET might predict early infarct growth in acute ischemic stroke patients with perfusion-diffusion mismatch in magnetic resonance imaging (MRI).
We prospectively enrolled acute ischemic stroke patients who visited the emergency room within 48 hours after stroke onset and had perfusion-diffusion mismatch (>20%), as shown MRI. Infarct growth was defined as >20% increase of initial infarct volume or >5 mL in follow-up diffusion-weighted image 5 ± 2 days after stroke. The association between FMISO uptake and infarct growth was explored.
Of 19 enrolled patients, 10 (52.6%) showed increased FMISO uptake, with 8 of the latter showing infarct growth. None of the 9 patients who did not show FMISO uptake had infarct growth. FMISO uptake was significantly associated with infarct growth (Fisher's exact test; P < .01). FMISO PET scan had a sensitivity of 100% and a specificity of 82% (AUC = .909) in predicting infarct growth.
FMISO PET scan can predict early infarct growth in acute ischemic stroke patients with perfusion-diffusion mismatch in MRI.
18F-氟米索硝唑（FMISO）正电子发射断层扫描（PET）用于对代谢受损但仍存活的缺氧组织进行成像。我们推测，FMISO PET可能预测磁共振成像（MRI）显示灌注-扩散不匹配的急性缺血性卒中患者早期梗死灶扩大。
我们前瞻性纳入了卒中发作后48小时内就诊且MRI显示灌注-扩散不匹配（>20%）的急性缺血性卒中患者。梗死灶扩大定义为卒中后5±2天的随访扩散加权图像中初始梗死灶体积增加>20%或增加>5 mL。探讨了FMISO摄取与梗死灶扩大之间的关联。
19例纳入患者中，10例（52.6%）显示FMISO摄取增加，其中8例出现梗死灶扩大。9例未显示FMISO摄取的患者均未出现梗死灶扩大。FMISO摄取与梗死灶扩大显著相关（Fisher精确检验；P<.01）。FMISO PET扫描预测梗死灶扩大的敏感性为100%，特异性为82%（AUC=.909）。
FMISO PET扫描可预测MRI显示灌注-扩散不匹配的急性缺血性卒中患者早期梗死灶扩大。
