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Correlation between Hyperintense Vessels on FLAIR Imaging and Arterial Circulation Time on Cerebral Angiography

 Seung Ha LEE  ;  Kwon Duk SEO  ;  Ji Hwa KIM  ;  Sang Hyun SUH  ;  Sung Jun AHN  ;  Kyung-Yul LEE 
 Magnetic Resonance in Medical Sciences, Vol.15(1) : 105-110, 2016 
Journal Title
 Magnetic Resonance in Medical Sciences 
Issue Date
Adult ; Aged ; Angiography, Digital Subtraction/methods ; Arachnoid/blood supply ; Basal Ganglia/blood supply ; Brain Ischemia/diagnosis* ; Brain Ischemia/physiopathology ; Carotid Artery, Internal/pathology ; Carotid Stenosis/diagnosis ; Carotid Stenosis/physiopathology ; Cerebral Angiography/methods* ; Cerebral Arterial Diseases/diagnosis ; Cerebral Arterial Diseases/physiopathology ; Cerebral Cortex/blood supply ; Cerebral Infarction/diagnosis ; Cerebral Infarction/physiopathology ; Collateral Circulation/physiology* ; Female ; Humans ; Magnetic Resonance Angiography/methods* ; Male ; Middle Aged ; Middle Cerebral Artery/pathology ; Retrospective Studies ; Stroke/diagnosis* ; Stroke/physiopathology ; Temporal Lobe/blood supply ; Tomography, X-Ray Computed/methods
arterial circulation time ; collateral circulation ; hyperintense vessel ; magnetic resonance image
PURPOSE: Hyperintense vessels (HVs) on fluid-attenuated inversion recovery (FLAIR) imaging are associated with the leptomeningeal collateral circulation in cases of arterial occlusive lesions. Nevertheless, the relationship between HVs on FLAIR imaging and arterial circulation time (ACT) on cerebral angiography has not been defined. METHODS: We analyzed images of 11 patients with acute occlusion of the distal internal carotid artery or proximal middle cerebral artery and calculated the difference in ACT (DACT) between infarcted and normal hemispheres. ACT was defined as the time interval from the initial opacification of the ipsilateral or contralateral cavernous internal carotid artery to the late arterial phase of the carotid artery territories. We scored HVs on FLAIR imaging using a modified Alberta Stroke Program Early Computerized Tomography Score (ASPECTS) and determined collateral circulation by grading collateral flow. RESULTS: We detected HVs on FLAIR images in 10 patients (median score, 4; range, 0 to 6). Comparison of infarcted and normal hemispheres demonstrated absent or subtle HVs on FLAIR imaging when the DACT was too short (<one second) or too long (>7.98 s) and prominent HVs with moderate DACT (2 to 5 s). The score of HVs on FLAIR was estimated well by DACT using a quadratic regression model (R(2) = 0.602) and better than by grading collateral flow (R(2) = 0.256). CONCLUSION: In cases of large arterial occlusion, the hyperintensity of vessels on FLAIR images may be dependent on arterial circulation time via retrograde filling of the leptomeningeal collateral circulation.
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1. College of Medicine (의과대학) > Dept. of Neurology (신경과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
Yonsei Authors
김지화(Kim, Ji Hwa)
서상현(Suh, Sang Hyun) ORCID logo https://orcid.org/0000-0002-7098-4901
안성준(Ahn, Sung Jun) ORCID logo https://orcid.org/0000-0003-0075-2432
이경열(Lee, Kyung Yul) ORCID logo https://orcid.org/0000-0001-5585-7739
이승하(Lee, Seung Ha)
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