Yonsei Med J.  2016 Jul;57(4):950-955. 10.3349/ymj.2016.57.4.950.

The Effect of Pulsatility Index on Infarct Volume in Acute Lacunar Stroke

• Kim Y
• Lee H
• An SA
• Yim B
• Kim J
• Kim OJ
• Kim WC
• Kim HS
• Oh SH
• Kim J

• KMID: 2374128
• DOI: http://doi.org/10.3349/ymj.2016.57.4.950

Abstract

PURPOSE
Lacunar stroke, in the context of small vessel disease, is a type of cerebral infarction caused by occlusion of a penetrating artery. Pulsatility index (PI) is an easily measurable parameter in Transcranial Doppler ultrasound (TCD) study. PI reflects distal cerebral vascular resistance and has been interpreted as a surrogate marker of small vessel disease. We hypothesized that an increased PI, a marker of small vessel disease, might be associated with a larger infarct volume in acute lacunar stroke.
MATERIALS AND METHODS
This study included 64 patients with acute lacunar stroke who underwent TCD and brain MRI. We evaluated the association between the mean PI value of bilateral middle cerebral arteries and infarct volume on diffusion-weighted MRI using univariate and multivariate linear regression.
RESULTS
The mean infarct volume and PI were 482.18±406.40 mm3 and 0.86±0.18, respectively. On univariate linear regression, there was a significant positive association between PI and infarct volume (p=0.001). In the multivariate model, a single standard deviation increase of PI (per 0.18) was associated with an increase of 139.05 mm3 in infarct volume (95% confidence interval, 21.25 to 256.85; p=0.022).
CONCLUSION
We demonstrated that PI was an independent determinant of infarct volume in acute lacunar stroke. The PI value measured in acute stroke may be a surrogate marker of the extent of ischemic injury.

Keyword

Transcranial Doppler; lacunar stroke; small vessel disease; diffusion MRI

MeSH Terms

Aged
Cerebral Infarction/*diagnostic imaging/*physiopathology
*Diffusion Magnetic Resonance Imaging
Female
Humans
Linear Models
Male
Middle Aged
Middle Cerebral Artery
Pulsatile Flow/physiology
Retrospective Studies
Stroke, Lacunar/*diagnostic imaging/*physiopathology
*Ultrasonography, Doppler, Transcranial
Vascular Resistance/physiology

Figure

• 

  Fig. 1 Scatter plot for pulsatility index and infarct volume. Each circle represents data for pulsatility index and infarct volume from a patient. Based on a linear regression model, the regression line (black) and 95% confidence interval (gray) for the regression line are drawn. There is a significant positive relationship between infarct volume and pulsatility index (r2=0.154, p=0.001).

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