Time-Threshold Curve Determined by Single Photon Emission CT in Patients with Acute Middle Cerebral Artery Occlusion
Tsutomu Isedaa,
Shinichi Nakanoa,
Takao Yanob,
Yukiko Suzukic and
Shinichiro Wakisakaa
a Department of Neurosurgery (T.I., S.N., S.W.), Miyazaki Medical College, Junwakai Memorial Hospital, Miyazaki, Japan
b Departments of Neurology (T.Y.), Junwakai Memorial Hospital, Miyazaki, Japan
c Departments of Radiology (Y.S.), Junwakai Memorial Hospital, Miyazaki, Japan
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FIG 1. Graph shows relationship between outcome in tissue regions that were successfully reperfused and ischemic duration/severity. Plots of AI (%) of irreversible (•) and reversible ( ) lesions versus ischemic duration are shown. A discriminant line of AI (%) = 21.53 time (h) - 19.15 (n = 35) within 3 hours of ischemic duration can be seen. There are six (17%) falsely discriminated ischemic lesions. A discriminant line of AI = 0.50 time - 48.27 (n = 92) after 3 hours’ ischemic duration can be seen. There are 10 (11%) falsely discriminated ischemic lesions.
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FIG 2. Case 9.
A, Final CT scan shows that an infarct occupied approximately half the right MCA territory. Posterior half of the MCA territory escaped cerebral infarction.
B, SPECT scan shows severe hypoperfusion with an AI of 14.89 in the anterior half of the MCA territory, which experienced infarction, and mild hypoperfusion with an AI of 70.82 in the posterior half of the MCA territory, which escaped infarction.
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