Bright and dark vessels on stroke imaging: different sides of the same coin?

Purpose: Prominent hypointense cerebral vessels on susceptibility-weighted imaging (SWI) and the hyperintense vessel sign (HVS) on fluid-attenuated inversion recovery (FLAIR) imaging are considered as markers of compromised tissue perfusion in cerebral ischemia. In this study, we aimed to identify t...

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Publicado en:Diagnostic & Interventional Radiology Vol. 22; no. 3; pp. 284 - 291
Autores principales: Vural, Atay, Gocmen, Rahsan, Oguz, Kader Karli, Topcuoglu, Mehmet Akif, Arsava, Ethem Murat
Formato: diagnostic images research tables/charts Journal Article
Publicado: Galenos Yayinevi Tic. LTD. STI May/Jun2016
Acceso en línea:Ver este registro en EBSCOhost
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      dt: May/Jun2016
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      pub: Galenos Yayinevi Tic. LTD. STI
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        atl: Bright and dark vessels on stroke imaging: different sides of the same coin?
      aug:
        au:
          Vural, Atay
          Gocmen, Rahsan
          Oguz, Kader Karli
          Topcuoglu, Mehmet Akif
          Arsava, Ethem Murat
        affil: Department of Neurology, Hacettepe University School of Medicine, Ankara, Turkey
      sug:
        subj:
          Cerebral Ischemia
          Stroke
          Infarction
          Retrospective Design
          Magnetic Resonance Imaging Methods
          Aged
          Aged, 80 and Over
          Male
          Infarction Pathology
          Middle Age
          Prognosis
          Female
          Human
          Aged: 65+ years
          Aged, 80 & over
          Middle Aged: 45-64 years
          Male
          Female
      ab: Purpose: Prominent hypointense cerebral vessels on susceptibility-weighted imaging (SWI) and the hyperintense vessel sign (HVS) on fluid-attenuated inversion recovery (FLAIR) imaging are considered as markers of compromised tissue perfusion in cerebral ischemia. In this study, we aimed to identify the correlation between HVS on FLAIR and hypointense vessels on SWI, and to determine whether these imaging features provide independent prognostic information in patients with ischemic stroke.Methods: We retrospectively analyzed consecutive ischemic stroke patients with proximal middle cerebral artery (MCA) occlusion who underwent SWI and FLAIR within 24 h of symptom onset. The presence of hypointense vessels on SWI and hyperintense vessels on FLAIR in >4 of 10 slices encompassing the MCA territory were considered to represent prominent hypoperfusion.Results: Among 50 patients, 62% had a prominent HVS on FLAIR and 68% had prominent hypointense vessels on SWI. There was a moderate but significant correlation between the number of slices with HVS on FLAIR and prominent hypointense vessels on SWI (r=0.425, P = 0.002). In multivariate analyses, the prominence of hypointense vessels on SWI, but not HVS on FLAIR, was significantly associated with a higher discharge NIHSS score (P = 0.027), mRS score (P = 0.021), and lesion growth (P = 0.050).Conclusion: The significant, albeit moderate, correlation between markers of compromised tissue perfusion on FLAIR and SWI suggests that these imaging features reflect different but interrelated aspects of cerebral hemodynamics during ischemic stroke. Our findings highlight that while HVS on FLAIR denotes the presence of leptomeningeal collaterals, hypointense vessels on SWI signify the sufficiency of cerebral blood flow at the tissue level and are therefore more critical in terms of prognosis.
      pubtype: Academic Journal
      doctype:
        diagnostic images
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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