Prognostic value of CT perfusion imaging, serum D-D and MMP-9 on hemorrhage transformation after thrombolysis in patients with acute cerebral infarction.

Background: This study explores the predictive value of Computerized Tomography (CT) perfusion imaging, serum D-dimer (D-D), and serum matrix metalloproteinase-9 (MMP-9) levels for hemorrhagic transformation (HT) in patients with acute cerebral infarction post-thrombolysis. Materials and Methods: Patients with acute cerebral infarction who underwent thrombolytic therapy from February 2021 to February 2022 were included. CT perfusion imaging was conducted within a week post-operation. The study compared CT perfusion parameters and serum markers, analyzing differences and conducting univariate and multivariate analyses to explore their predictive value for HT. Results: No significant differences were found in hypertension, hyperlipidemia, stroke history, mean arterial pressure, fasting blood glucose, and platelet count pre-thrombolysis (P > 0.05). However, infarct diameter = 5 cm and atrial fibrillation were more common in the study group, with higher pre-thrombolysis National Institutes of Health Stroke Scale (NIHSS) score, D-D, and MMP-9 levels (P < 0.05). CT perfusion showed lower relative cerebral blood volume (rCBV, relative cerebral blood flow (rCBF, and higher relative mean transit time (rMTT), relative time to peak (rTTP) in the study group (P < 0.05). D-D and MMP-9 levels were negatively correlated with rCBV, rCBF, and positively with rTTP, CTP integration index (P < 0.05). Conclusion: CT perfusion imaging, serum D-D, and MMP-9 levels are effective predictors of hemorrhagic transformation in acute cerebral infarction patients postthrombolysis. These findings are valuable for guiding clinical treatment and monitoring. [ABSTRACT FROM AUTHOR]