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Hyperintense Vessels on T2-PROPELLER-FLAIR in Patients with Acute MCA Stroke: Prediction of Arterial Stenosis and Perfusion Abnormality

Authors
 S.J. Ahn  ;  S.H. Suh  ;  K.-Y. Lee  ;  J.H. Kim  ;  K.-D. Seo  ;  S. Lee 
Citation
 American Journal of Neuroradiology, Vol.36(11) : 2042-2047, 2015 
Journal Title
 American Journal of Neuroradiology 
ISSN
 0195-6108 
Issue Date
2015
MeSH
Aged ; Female ; Humans ; Infarction, Middle Cerebral Artery/pathology* ; Magnetic Resonance Imaging/methods* ; Male ; Middle Aged ; Perfusion ; Retrospective Studies
Abstract
BACKGROUND AND PURPOSE: Fluid-attenuated inversion recovery hyperintense vessels in stroke represent leptomeningeal collateral flow. We presumed that FLAIR hyperintense vessels would be more closely associated with arterial stenosis and perfusion abnormality in ischemic stroke on T2-PROPELLER-FLAIR than on T2-FLAIR. MATERIALS AND METHODS: We retrospectively reviewed 35 patients with middle cerebral territorial infarction who underwent MR imaging. FLAIR hyperintense vessel scores were graded according to the number of segments with FLAIR hyperintense vessels in the MCA ASPECTS areas. We compared the predictability of FLAIR hyperintense vessels between T2-PROPELLER-FLAIR and T2-FLAIR for large-artery stenosis. The interagreement between perfusion abnormality and FLAIR hyperintense vessels was assessed. In subgroup analysis (9 patients with MCA horizontal segment occlusion), the association of FLAIR hyperintense vessels with ischemic lesion volume and perfusion abnormality volume was evaluated. RESULTS: FLAIR hyperintense vessel scores were significantly higher on T2-PROPELLER-FLAIR than on T2-FLAIR (3.50 ± 2.79 versus 1.21 ± 1.47, P < .01), and the sensitivity for large-artery stenosis was significantly improved on T2-PROPELLER-FLAIR (93% versus 68%, P = .03). FLAIR hyperintense vessels on T2-PROPELLER-FLAIR were more closely associated with perfusion abnormalities than they were on T2-FLAIR (κ = 0.64 and κ = 0.27, respectively). In subgroup analysis, FLAIR hyperintense vessels were positively correlated with ischemic lesion volume on T2-FLAIR, while the mismatch of FLAIR hyperintense vessels between the 2 sequences was negatively correlated with ischemic lesion volume (P = .01). CONCLUSIONS: In MCA stroke, FLAIR hyperintense vessels were more prominent on T2-PROPELLER-FLAIR compared with T2-FLAIR. In addition, FLAIR hyperintense vessels on T2-PROPELLER-FLAIR have a significantly higher sensitivity for predicting large-artery stenosis than they do on T2-FLAIR. Moreover, the areas showing FLAIR hyperintense vessels on T2-PROPELLER-FLAIR were more closely associated with perfusion abnormality than those on T2-FLAIR.
Full Text
http://www.ajnr.org/content/36/11/2042
DOI
10.3174/ajnr.A4423
Appears in Collections:
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
Kim, Ji Hwa(김지화)
Suh, Sang Hyun(서상현) ORCID logo https://orcid.org/0000-0002-7098-4901
Ahn, Sung Jun(안성준) ORCID logo https://orcid.org/0000-0003-0075-2432
Lee, Kyung Yul(이경열) ORCID logo https://orcid.org/0000-0001-5585-7739
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/156746
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