Magnetic Resonance Angiography :Its Role in Early Thrombolytic Theraphy -Preliminary study-

J Korean Neurol Assoc > Volume 13(3); 1995 > Article

Journal of the Korean Neurological Association 1995;13(3): 473-478.

조기 혈전용해 치료에 있어 자기공명 혈관조영술의 유용성-예비적 연구-

윤신구, 방차옥, 박형국, 안무영, 신현길

순천향대학교 천안병원 신경과

Magnetic Resonance Angiography :Its Role in Early Thrombolytic Theraphy -Preliminary study-

Shin Koo Youn, M.D., Cha Ok Bang, M.D., Hyung Kook Park, M.D., Mu Young Ahn M.D., Hyun Kil Shin M.D.

Department of Neurology, Soonchunhyang University Chunan Hospital

Abstract

In early thrombolytic therapy for acute focal ischemic stroke, the start of treatment within therapeutic time window is one of the most important thing. Recently, new imaging modalities such as SPECT, transcranial doppler, diffusion/ perfusion-weighted MRI, and MR anglography have been implicated to avoid time consumption and delayed therapy. Of these, MR angiography is nomnvasi and rapid technique to visualize large and medium-sized arteries. We explored the usefulness of MR angiography in early thrombolytic therapy. Arterial occlusion of three patients with severe ischemic stroke were demonstrated on MR anglography and wluch were treated with Urokmase (10, 000-20, 000 units/kg) by intravenous infusion within 2-4 hours after symptom onset. Recanalization and brain lesion was assessed by repeated MR angiography and MRI or CT 24 hours later. Clinical improvement was observed in two patients 5-24 hours after initiation of treatment. In one patient hemorrhagic infarction without clinical deterioration was detected by follow-up computed tomography. Recanalization was documented on repeated MR angiography of three patients. MR angiography can document occlusion of stroke-related vasculature without delay of thrombolytic therapy and repeated MR anglography can reveal whether recanalization has occurred.