Comparison Influence to Prognosis of CTP and MRP in AIS Patients

This is a prospective, non-blind, single-center clinical trial to evaluate whether baseline computed tomography perfusion (CTP) profiles have a comparable ability to magnetic resonance perfusion (MRP) in identifying acute ischemia stroke (AIS) patients who have a robust clinical response after early reperfusion.

The study will enroll 1000 patients, and patients will be divided into 2 groups according to the imaging available situation (to see which can provide immediately): CTP scan group and MRP scan group.

Core: CT: cerebral blood flow <30% of that in normal tissue / MR: ADC < 600 ×D10-6 mm2 / s.

Hypoperfusion: CT / MR: time to maximum >6.

For patients accepting CTP or MRP over 4.5 hours after stroke onset, only patients who meet imaging criteria (infarct core volume < 70mL, perfusion lesion volume / infarct core volume >1.2, and absolute mismatch >10 mL) at baseline will receive recombinant tissue plasminogen activator (rt-PA) intravenous thrombolysis. CTP or MRP will be performed at 24 hours after thrombolytic therapy. Modified Rankin score (mRS) will be measured at 3 months after stroke onset.

Study Endpoints: Primary endpoint: mRS 0-2 at 3 months. Secondary endpoints: (1) symptomatic intracranial haemorrhage, (2) reperfusion, (3) recanalization, and (4) infarct growth at 24 hours.

Criteria:

Inclusion criteria

• Provision of informed consent;
• Male and female adults aged 18-80 years old;
• For patients accepting CTP or MRP over 4.5 hours after stroke onset, imaging criteria: infarct core volume <70mL, perfusion leison volume / infarct core volume >1.2, and absolute mismatch >10 mL.

Exclusion criteria

• Standard contraindications to rt-PA;
• Contraindication to imaging with contrast agents;
• Pre-stroke mRS score of ≥2 (indicating previous disability);
• Participation in any investigational study in the previous 30 days;
• Any terminal illness such that patient would not be expected to survive more than one-year.

Criteria:

Inclusion criteria

• Provision of informed consent;
• Male and female adults aged 18-80 years old;
• For patients accepting CTP or MRP over 4.5 hours after stroke onset, imaging criteria: infarct core volume <70mL, perfusion leison volume / infarct core volume >1.2, and absolute mismatch >10 mL.

Exclusion criteria

• Standard contraindications to rt-PA;
• Contraindication to imaging with contrast agents;
• Pre-stroke mRS score of ≥2 (indicating previous disability);
• Participation in any investigational study in the previous 30 days;
• Any terminal illness such that patient would not be expected to survive more than one-year.