The dynamic change of MR imaging in acute ischemic stroke with tPA therapy

Abstract

We investigated the dynamic change of MR imaging in acute ischemic stroke with the tPA therapy in our hospital where 3.0T-MRI can support for 24 hours. The clinical data for 62 patients who received intravenous tPA for acute ischemic stroke and MR imaging before, during, and after the tPA of between April 2012 and December 2015. We investigated the change of MR imaging and clinical observation. Nineteen patients (24%) achieved early recanalization more than TICI 2A during tPA or TICI 2B within 8 hours of symptom onset. The DWI lesion reduction (DWI LR) was observed in 6 (10%) patients. In 30 minutes after the tPA, 63% of early recanalization group achieved TICI 2B, and DWI LR was observed in some cases. Early recanalization was related to the DWI LR, dramatic improvement of symptom and good outcome. NIHSS (22 in the LR group, and 16 in the non-LR group) and ASPECTS+W (7 in the LR group, and 8 in the non-LR group) were significantly different in early recanalization group. DWI lesion which disappeared in early phase might regrow between subacute and clonic phase. MR imaging changed dynamically in a short term after the tPA therapy. Early recanalization provides the dramatic improvement of symptom and good outcome, and reduces the DWI lesion of the relatively wide infarction range.