Multi-modality magnetic resonance imaging-guided intravenous thrombolysis in acute cerebral infarction

Objective To evaluate the efficacy and safety of multi-modality MRI-guided intravenous thrombolysis in treatment of acute cerebral infarction.Methods A total of 40 patients with acute cerebral infarction were enrolled.All patients showed normal CT scan and met NINDS thrombolysis criterion.They received scanning by multi-modality MRI to assess risks and potential benefits of thrombolysis.Fourteen patients who had no thrombolysis contraindication were administrated with intravenous recombinant tissue plasminogen activator(rt-PA,0.9 mg/kg).The assessment using National Institutes of Health Stroke Scale(NIHSS)score and Barthel Index(BI)was made before and after treatment.Modified Rankin's Score(mRS)on 90th day was also assessed.Results Fourteen patients received rt-PA therapy.Their NIHSS score was(6.42±5.38)at 24 h,(3.64±3.05)and(0.86±1.17)on 21st day and 90th day after thrombolytic therapy respectively.Their BI score was(18.93±6.26)before therapy,(50.36±35.22)and(88.93±13.21)on 21st day and 90th day after thromolytic therapy respectively.These scores significantly decreased compared with the score before treatment(P0.01).Conclusion Intravenous thrombolysis with rt-PA within 4.5 hours after symptom onset for acute cerebral infarction is safe and effective.Multi-modality MRI is helpful to choosing the patients who may be benefited from thrombolysis therapy and excluding the patients who are at risk of bleeding after thrombolysis.