Radiology Medical News about early deterioration;low risk;Lacunar infarcts;magnetic resonance perfusion-weighted imaging

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Normal magnetic resonance perfusion-weighted imaging in lacunar infarcts predicts a low risk of early deterioration
Cerebrovascular Diseases, 06/19/09

Poppe AY et al. – Findings show MR-perfusion-weighted imaging (PWI) abnormalities in 2/3 of lacunar infarcts as associated with stroke vs TIA. Normal PWI identifies pts at low risk of early clinical deterioration.

Methods

Study of the occurrence of MR-PWI abnormalities in lacunes and whether they help predict clinical and radiological outcome
Prospective MR imaging study of pts with lacunar stroke or TIA
MRI within 24 hr of event and follow-up imaging completed at 30 or 90 days
Baseline perfusion maps qualitatively assessed and infarct volumes measured
Recording of early clinical deterioration (NIHSS worsening of ≥3 points within 72 hr of event) and 90-day modified Rankin Scale score (mRS)

Results

Of 22 pts, 15 (68.2%) had abnormal PWI at site of diffusion-weighted imaging lesion
Pts with abnormal PWI more likely to have stroke vs TIA as index event
Clinical deterioration in 4 pts (18.2%), all with abnormal PWI
PWI lesions not associated with higher 90-day NIHSS or mRS score
PWI lesions did not predict infarct volume growth

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