Development of a simple perfusion score for mechanical thrombectomy
| Project/Area Number |
16K09731
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| Research Category |
Grant-in-Aid for Scientific Research (C)
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| Allocation Type | Multi-year Fund |
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| Section | 一般 |
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| Research Field |
Neurology
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| Research Institution | Kyorin University |
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Principal Investigator |
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| Project Period (FY) |
2016-04-01 – 2019-03-31
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| Project Status |
Completed (Fiscal Year 2018)
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| Budget Amount *help |
¥4,680,000 (Direct Cost: ¥3,600,000、Indirect Cost: ¥1,080,000)
Fiscal Year 2018: ¥1,430,000 (Direct Cost: ¥1,100,000、Indirect Cost: ¥330,000)
Fiscal Year 2017: ¥1,300,000 (Direct Cost: ¥1,000,000、Indirect Cost: ¥300,000)
Fiscal Year 2016: ¥1,950,000 (Direct Cost: ¥1,500,000、Indirect Cost: ¥450,000)
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| Keywords | 血栓回収療法 / 脳梗塞急性期 / MRI / FLAIR / 灌流画像 / 神経科学 / 神経機能画像学 / 脳血行再建療法 |
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| Outline of Final Research Achievements |
Many RCT of acute mechanical thrombectomy employed CT-perfusion study to select good responders. However, perfusion imaging is not commonly available in Japanese routine practice. MRI fluid-attenuated inversion recovery (FLAIR) image is known to link with cerebral hypoperfusion at the area of FLAIR hyperintense vessel (FHV). In this study, therefore, a simple score to evaluate cerebral perfusion employing FHV was developed. Using 25 patients with emergent large vessel occlusion (ELVO), presence of FHV was evaluated on 175 cortical lesions of ASPECTS+W. 89 lesions (51%) with positive-FHV tend to have positive-DWI compared to those of negative-FHV (56% vs. 17%, p<0.0001). Moreover, positive-FHV lesions progressed to infarction despite early (<6 hour) TICI 2b/3 recanalization (55% vs. 29%, p=0.0234). This simple perfusion score using FHV, therefore, will increase the accuracy of perfusion and core estimates on top of DWI evaluation.
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| Academic Significance and Societal Importance of the Research Achievements |
脳梗塞救急現場で一般に行われている画像評価の中から、灌流情報を見極めるためのポイントを明らかにした。治療前に余分な検査時間を割く必要がなく、結果として治療開始までの時間は短縮され患者転帰改善に寄与できると考える。また、どの施設でも実施可能な評価法であり、臨床現場での有用性は極めて高い。
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Report
(4 results)
Research Products
(43 results)
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[Journal Article] Rivaroxaban administration after acute ischemic stroke: the RELAXED study2019
Author(s)
Yasaka M, Minematsu K, Toyoda K, Mori E, Hirano T, Hamasaki T, Yamagami H, Nagao T, Yoshimura S, Uchiyama S, for the RELAXED study group
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Journal Title
PLOS ONE
Volume: 14
Issue: 2
Pages: 774-781
DOI
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Peer Reviewed / Open Access
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[Journal Article] New diagnostic criteria for cerebral autosomal dominant arteriopathy with subcortical infarcts and leukocencephalopathy in Japan.2017
Author(s)
Mizuta I, Hosomi-Watanabe A, Koizumi T, Mukai M, Hamano A, Tomii Y, Kondo M, Nakagawa M, Tomimoto H, Hirano T, Uchino M, Onodera O, Mizuno T
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Journal Title
J Neurol Sci
Volume: 381
Pages: 62-67
DOI
Related Report
Peer Reviewed / Open Access / Int'l Joint Research
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[Journal Article] Design and Rationale of the RELAXED (Recurrent Embolism Lessened by rivaroxaban, an Anti-Xa agent, of Early Dosing for acute ischemic stroke and transient ischemic attack with atrial fibrillation) Study.2016
Author(s)
Yasaka M, Minematsu K, Toyoda K, Yamagami H, Yoshimura S, Nagao T, Mori E, Hirano T, Hamasaki T, Yamaguchi T.
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Journal Title
J Stroke Cerebrovasc Dis
Volume: 25
Issue: 6
Pages: 1342-8
DOI
Related Report
Peer Reviewed
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[Book] マスター脳卒中学2019
Author(s)
平野照之（分担執筆）
Total Pages
587
Publisher
西村書店
ISBN
9784890134939
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