In symptomatic patients with cerebrovascular steno-occlusive disease, impaired blood oxygenation level–dependent cerebrovascular reactivity (BOLD-CVR) and increased flow velocity of the P₂ segment of the posterior cerebral artery (PCA-P₂) on transcranial Doppler (TCD) ultrasonography have been introduced as emerging clinical imaging parameters to identify patients at high risk for recurrent ischemic events. Since hemodynamic physiology differs between the acute and chronic stages of ischemic stroke, the authors sought to investigate whether those parameters have merit for both the acute and chronic stages of ischemic stroke.

From a prospective database, patients who underwent BOLD-CVR and TCD examinations in the acute stroke stage (< 10 days) were matched to patients in the chronic stroke stage (> 3 months). A linear regression analysis for both groups was performed between ipsilateral PCA-P₂ systolic flow velocity and BOLD-CVR of the ipsilateral (affected) hemisphere, the ipsilateral middle cerebral artery (MCA) territory, and the ipsilateral steal volume (i.e., paradoxical BOLD-CVR response). The resulting slopes and intercepts were statistically compared to evaluate differences between groups.

Forty matched patient pairs were included. Regression analysis showed no significant difference for either the intercept (p = 0.84) or the slope (p = 0.85) between PCA-P₂ flow velocity and BOLD-CVR as measured for the ipsilateral (affected) hemisphere. Similarly, no significant difference was seen between PCA-P₂ flow velocity and BOLD-CVR of the ipsilateral MCA territory (intercept, p = 0.72; slope, p = 0.36) or between PCA-P₂ flow velocity and steal volume (intercept, p = 0.59; slope, p = 0.34).

The study results indicated that the relationship between ipsilateral PCA-P₂ systolic flow velocity and BOLD-CVR remains the same during the acute and chronic stages of ischemic stroke. This provides further support that these novel hemodynamic imaging parameters may have merit to assess the risk for recurrent ischemic events for a wide ischemic stroke population. PCA-P₂ systolic flow velocity, in particular, may be a highly practical screening tool, independent of ischemic stroke stage.

在有症状的脑血管狭窄闭塞性疾病患者中，经颅多普勒 (TCD) 超声检查显示血氧水平依赖性脑血管反应性 (BOLD-CVR) 受损和大脑后动脉P ₂段 (PCA-P ₂ )流速增加已被引入作为新兴的临床成像参数来识别具有复发性缺血事件高风险的患者。由于缺血性中风急性期和慢性期的血流动力学生理学不同，作者试图调查这些参数是否对缺血性中风的急性期和慢性期都有价值。

从前瞻性数据库中，在急性卒中阶段（<10 天）接受 BOLD-CVR 和 TCD 检查的患者与慢性卒中阶段（> 3 个月）的患者相匹配。对两组的同侧 PCA-P ₂收缩流速和同侧（受影响）半球的 BOLD-CVR、同侧大脑中动脉（MCA）区域和同侧窃血量（即矛盾的 BOLD）进行线性回归分析-CVR 响应）。统计比较所得斜率和截距以评估组间差异。

包括四十对匹配的患者。回归分析显示 PCA-P ₂流速和 BOLD-CVR之间的截距 (p = 0.84) 或斜率 (p = 0.85) 没有显着差异，如为同侧（受影响）半球测量。同样，PCA-P ₂流速和同侧 MCA 区域的 BOLD-CVR 之间（截距，p = 0.72；斜率，p = 0.36）或 PCA-P ₂流速和窃取体积（截距， p = 0.59；斜率，p = 0.34）。

研究结果表明，在缺血性卒中的急性和慢性阶段，同侧 PCA-P ₂收缩流速与 BOLD-CVR之间的关系保持不变。这进一步支持这些新的血流动力学成像参数可能有助于评估广泛缺血性卒中人群的复发性缺血事件风险。特别是 PCA-P ₂收缩期流速可能是一种非常实用的筛选工具，与缺血性中风阶段无关。