The usefulness and the roles of diffusion weighted imaging and XeCT at the ultra-acute stage of major cerebral artery occlusion.

Sugimoto Koichi, Sato Naoaki, Matsumura Akira, Nose Tadao

doi:10.3995/jstroke.20.584

The roles and the usefulness of diffusion weighted imaging (DWI) and Xenon Computed Tomography (XeCT) were studied in the cases of major cerebral artery occlusion at the ultra-acute stage. In 12 cases, both DWI and XeCT were examined within 6 hours after onset to decide on the therapeutic strategy. The subjects were 8 males and 4 females, aged 48 to 87 wigh an average age of 70.3). The interval from onset To DWI was from one hour and thiety minutes to five hours and thirty minutes with an average time of three hours. No abnormal findings were found in any of the cases on the routine CT, MRI-T2WI◊FLAIR, while large abnormal findings appeared on the DWI in all the cases. On the XeCT, the decreased cerebral blood flow (CBF) in the ischemic area was shown. This area corresponded to the one showen on DWI. Superselective intraaterial thrombolysis was performed in 5 cases, from which 2 were discharged ambulatorily, 2 wheeling themselves out, and 1 is still bedridden. Conservative therapy was performed in 7 cases. Three followed a good course and had relative good CBFs in the ischemic area. The four cases with poor prognosis of death or being bedridden consisted of the ones with the bilateral lesions, those with an age of over 75 and some complications, or those with the involved area of CBF<10 ml/100 g/min. DWI and XeCT were very useful at the ultra-acute stage of major cerebral artery occlusion because time is extremely important in deciding on the therapeutic strategy including thrombolysis. DWI provided a definite diagnosis in a short time at the ultra-acute stage and XeCT provided the decision of thrombolysis and the prediction of the prognosis.

The usefulness and the roles of diffusion weighted imaging and XeCT at the ultra-acute stage of major cerebral artery occlusion.

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