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【medical-news】MRI profiles predict utility of reperfusion
11/22/2006
By: Reuters Health
NEW YORK (Reuters Health), Nov 22 - Baseline MRI findings can help determine when reperfusion therapy is likely to be beneficial for stroke patients who are treated three to six hours after symptom onset, according to results of the Diffusion and Perfusion Imaging Evaluation for Understanding Stroke Evolution (DEFUSE) study.
In the November issue of the Annals of Neurology, Dr. Gregory W. Albers, from Stanford University in Standford, CA, and colleagues note that they had been using novel MRI techniques to characterize the brain damage from stroke as it was occurring. Over time, the researchers began to notice specific MRI patterns that seemed to identify brain tissue that was potentially salvageable and, therefore, might benefit from reperfusion therapy.
"One of the criticisms was that these detailed brain images looked beautiful and interesting," Dr. Albers said in a statement, "but there was no proof that they should be used to influence treatment or that they would result in improved outcomes. How do you know that these MRI patterns can predict whether the therapy is likely to be beneficial?"
To address these issues, the researchers analyzed MRI profiles obtained in 74 consecutive stroke patients. The subjects were treated with tissue plasminogen activator three to six hours after stroke onset and MRI was performed immediately before and a few hours after treatment.
Patients with perfusion/diffusion mismatch on the baseline MRI had a 5.4-fold increased likelihood of achieving a favorable clinical response with reperfusion therapy, defined as little or no stroke symptoms at 30 days or a significant improvement in symptoms. Moreover, the presence of this mismatch in the absence of a previously identified "malignant" MRI profile increased the likelihood of such a response by 8.7-fold.
Patients with no mismatch on the baseline MRI did not benefit from reperfusion therapy. Those with the malignant profile had an elevated risk of fatal intracranial hemorrhage.
"By having this additional (MRI) information available," Dr. Albers pointed out, "we should be able to make a much more sophisticated decision about which therapies are optimal for an individual patient, especially as you get into the longer time windows" from symptom onset to treatment.
Last Updated: 2006-11-21 15:13:27 -0400 (Reuters Health)
Ann Neurol 2006 本人认领这篇，如果48小时未交稿，其他战友自由认领 太短了，这篇 磁共振片在中风的再灌注治疗中的预测作用
11/22/2006
By: Reuters Health
纽约（路透社 健康），11月22日——通过对磁共振片弥散相和灌注相的分析了解中风的变化过程(DEFUSE)，对于在症状出现后3到6小时得到治疗的中风病人，有助于发现何时进行再灌注治疗对患者有利。
在11月出版的神经病学年报上，斯坦福大学的Dr. Gregory W. Albers提出，他们一直在应用新的磁共振成像技术，当中风发生时，确定大脑的损害状况。逐渐的，研究者们开始认识到，应用特定的磁共振成像技术可以鉴别哪些脑组织可能是有潜在救治价值的，从而对其行再灌注治疗。
“有批评说：这些清晰的脑部图像非常漂亮而吸引人，” Dr. Albers说，“但是没有证据表明它对治疗有指导作用或者因为它患者的预后得到改善。人们会问：你们是怎么知道这些磁共振成像技术有助于指导治疗？”
为了阐明这个问题，研究者分析了74个中风患者的磁共振成像图片。这些患者在中风发生后3到6小时给予组织纤维蛋白溶酶原激活剂治疗，在治疗之前或者治疗后几小时行磁共振成像术。
在基础磁共振成像片上出现灌注/弥散异常的患者，通过再灌注治疗，取得良好临床效果的可能性增高了5.4倍，临床效果是指：30天无中风症状或者症状明显改善。此外，在以前没有诊为“恶性病变”的磁共振成像片上出现灌注/弥散异常，可以使取得良好临床效果的可能性增高8.7倍。
在基础磁共振成像片上未出现灌注/弥散异常的患者，再灌注治疗对其没有益处。 在基础磁共振成像片上未出现恶性病变的患者，其重大颅内出血有较高的风险。
“结合这些有用的辅助信息（磁共振成象），” Dr. Albers指出，“对于每个不同的患者，究竟哪一种治疗是最佳的？我们能够做出更成熟的决定。especially as you get into the longer time windows”从出现症状到治疗。
上次更新: 2006-11-21 15:13:27 -0400 (路透社 健康)
Ann Neurol 2006 perfusion/diffusion mismatch 我翻译为“灌注/弥散异常”，
Baseline MRI profile 我翻译为“基础磁共振片”，是否正确，
还有最后一句：especially as you get into the longer time windows，该如何翻译比较好
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作者:admin@医学,生命科学 2011-02-24 17:11
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