nach oben

Erschienen in:

14.02.2019 | Head and Neck

FLAIR vascular hyperintensity in acute stroke is associated with collateralization and functional outcome

verfasst von: Liang Jiang, Yu-Chen Chen, Hong Zhang, Mingyang Peng, Huiyou Chen, Wen Geng, Quan Xu, Xindao Yin, Yuehu Ma

Erschienen in: European Radiology | Ausgabe 9/2019

Einloggen, um Zugang zu erhalten

Abstract

Purpose

Fluid-attenuated inversion recovery vascular hyperintensity (FVH) is frequently found in stroke patients after intracranial arterial occlusion, but the prognostic value of FVH findings is unclear. We assessed whether FVH is associated with cerebral collateral status and functional outcome in patients with acute stroke patients receiving endovascular therapy.

Methods

FVH score, American Society of Interventional and Therapeutic Neuroradiology (ASITN) grade, the functional outcome at 3 months (modified Rankin Scale (mRS)), and other clinical data were collected for 37 acute stroke patients with large vessel occlusion (LVO) receiving MRI before and after endovascular therapy. Statistical analysis was performed to predict functional outcome after stroke.

Results

The good functional outcome group (n = 16) had a higher FVH₁ (FVH before therapy) score (4.63 ± 1.20 vs 3.14 ± 1.15; p = 0.001) and ASITN grade (3.31 ± 0.48 vs 2.00 ± 1.22; p < 0.001) and a lower FVH₂ (FVH after therapy) score than the poor functional outcome group (n = 21; 0.125 ± 0.50 vs 1.44 ± 2.16; p = 0.030). mRS at 3 months was negatively correlated with FVH₁ (r = − 0.525, p = 0.001) and the ASITN grade (r = − 0.478, p = 0.003) and positively correlated with FVH₂ (r = 0.376, p = 0.034). FVH₁ (OR, 0.085; 95% CI, 0.013–0.577; p = 0.012) and FVH₂ (OR, 2.724; 95% CI, 1.061–6.996; p = 0.037) were independently associated with functional outcome in multivariable logistic regression analysis.

Conclusions

Assessing FVH before and after therapy in acute stroke patients with LVO might be useful for predicting functional outcome after stroke.

Key Points

• Fluid-attenuated inversion recovery vascular hyperintensity is a circular or serpentine brightening in the brain parenchyma or cortical surface bordering the subarachnoid space on MR imaging.

• A prospective study showed that fluid-attenuated inversion recovery vascular hyperintensity is associated with cerebral collateral circulation and prognosis.

• Fluid-attenuated inversion recovery vascular hyperintensity helps clinicians to predict the prognosis of patients with acute stroke.

Siegler JE, Boehme AK, Kumar AD et al (2013) Identification of modifiable and nonmodifiable risk factors for neurologic deterioration after acute ischemic stroke. J Stroke Cerebrovasc Dis 22:e207–e213CrossRefPubMed

Bang OY, Goyal M, Liebeskind DS (2015) Collateral circulation in ischemic stroke: assessment tools and therapeutic strategies. Stroke 46:3302–3309CrossRefPubMedPubMedCentral

McVerry F, Liebeskind DS, Muir KW (2012) Systematic review of methods for assessing leptomeningeal collateral flow. AJNR Am J Neuroradiol 33:576–582CrossRefPubMedPubMedCentral

Seker F, Potreck A, Möhlenbruch M, Bendszus M, Pham M (2016) Comparison of four different collateral scores in acute ischemic stroke by CT angiography. J Neurointerv Surg 8:1116–1118CrossRefPubMed

Ichijo M, Iwasawa E, Numasawa Y et al (2015) Significance of development and reversion of collaterals on MRI in early neurologic improvement and long-term functional outcome after intravenous thrombolysis for ischemic stroke. AJNR Am J Neuroradiol 36:1839–1845CrossRefPubMedPubMedCentral

Liebeskind DS (2005) Collaterals in acute stroke: beyond the clot. Neuroimaging Clin N Am 15:553–573 xCrossRefPubMed

Martinon E, Lefevre PH, Thouant P, Osseby GV, Ricolfi F, Chavent A (2014) Collateral circulation in acute stroke: assessing methods and impact: a literature review. J Neuroradiol 41:97–107CrossRefPubMed

Azizyan A, Sanossian N, Mogensen MA, Liebeskind DS (2011) Fluid-attenuated inversion recovery vascular hyperintensities: an important imaging marker for cerebrovascular disease. AJNR Am J Neuroradiol 32:1771–1775CrossRefPubMedPubMedCentral

Zhai DY, Zhu SG, Zhang W, Li X, Zhu YL (2017) Infarct morphology assessment in patients with carotid artery/middle cerebral artery occlusion using fast fluid-attenuated inversion recovery (FLAIR) vascular hyperintensity (FVH). PLoS One 12:e0188078CrossRefPubMedPubMedCentral

10.

Liu D, Scalzo F, Rao NM et al (2016) Fluid-attenuated inversion recovery vascular hyperintensity topography, novel imaging marker for revascularization in middle cerebral artery occlusion. Stroke 47:2763–2769CrossRefPubMedPubMedCentral

11.

Hamano E, Kataoka H, Morita N et al (2017) Clinical implications of the cortical hyperintensity belt sign in fluid-attenuated inversion recovery images after bypass surgery for moyamoya disease. J Neurosurg 126:1–7CrossRefPubMed

12.

Kufner A, Galinovic I, Ambrosi V et al (2015) Hyperintense vessels on FLAIR: hemodynamic correlates and response to thrombolysis. AJNR Am J Neuroradiol 36:1426–1430CrossRefPubMedPubMedCentral

13.

Sanossian N, Saver JL, Alger JR et al (2009) Angiography reveals that fluid-attenuated inversion recovery vascular hyperintensities are due to slow flow, not thrombus. AJNR Am J Neuroradiol 30:564–568CrossRefPubMedPubMedCentral

14.

Hohenhaus M, Schmidt WU, Brunecker P et al (2012) FLAIR vascular hyperintensities in acute ICA and MCA infarction: a marker for mismatch and stroke severity? Cerebrovasc Dis 34:63–69CrossRefPubMed

15.

Nave AH, Kufner A, Bücke P et al (2018) Hyperintense vessels, collateralization, and functional outcome in patients with stroke receiving endovascular treatment. Stroke 49:675–681CrossRefPubMed

16.

Legrand L, Tisserand M, Turc G et al (2015) Do FLAIR vascular hyperintensities beyond the DWI lesion represent the ischemic penumbra? AJNR Am J Neuroradiol 36:269–274CrossRefPubMedPubMedCentral

17.

Higashida RT, Furlan AJ, Roberts H et al (2003) Trial design and reporting standards for intra-arterial cerebral thrombolysis for acute ischemic stroke. Stroke 34:e109–e137CrossRefPubMed

18.

Singer OC, Berkefeld J, Nolte CH et al (2015) Collateral vessels in proximal middle cerebral artery occlusion: the ENDOSTROKE study. Radiology 274:851–858CrossRefPubMed

19.

Liu W, Xu G, Yue X et al (2011) Hyperintense vessels on FLAIR: a useful non-invasive method for assessing intracerebral collaterals. Eur J Radiol 80:786–791CrossRefPubMed

20.

Mahdjoub E, Turc G, Legrand L et al (2018) Do fluid-attenuated inversion recovery vascular hyperintensities represent good collaterals before reperfusion therapy? AJNR Am J Neuroradiol 39:77–83CrossRefPubMedPubMedCentral

21.

Schellinger PD, Chalela JA, Kang DW, Latour LL, Warach S (2005) Diagnostic and prognostic value of early MR imaging vessel signs in hyperacute stroke patients imaged <3 hours and treated with recombinant tissue plasminogen activator. AJNR Am J Neuroradiol 26:618–624PubMedPubMedCentral

22.

Cheng B, Ebinger M, Kufner A et al (2012) Hyperintense vessels on acute stroke fluid-attenuated inversion recovery imaging: associations with clinical and other MRI findings. Stroke 43:2957–2961CrossRefPubMedPubMedCentral

23.

Kono T, Naka H, Nomura E et al (2014) The association between hyperintense vessel sign and final ischemic lesion differ in its location. J Stroke Cerebrovasc Dis 23:1337–1343CrossRefPubMed

24.

Gawlitza M, Gragert J, Quaschling U, Hoffmann KT (2014) FLAIR-hyperintense vessel sign, diffusion-perfusion mismatch and infarct growth in acute ischemic stroke without vascular recanalisation therapy. J Neuroradiol 41:227–233CrossRefPubMed

25.

Noguchi K, Ogawa T, Inugami A et al (1997) MRI of acute cerebral infarction: a comparison of FLAIR and T2-weighted fast spin-echo imaging. Neuroradiology 39:406–410CrossRefPubMed

26.

Zaidat OO, Yoo AJ, Khatri P et al (2013) Recommendations on angiographic revascularization grading standards for acute ischemic stroke: a consensus statement. Stroke 44:2650–2663CrossRefPubMedPubMedCentral

27.

Lee KY, Latour LL, Luby M, Hsia AW, Merino JG, Warach S (2009) Distal hyperintense vessels on FLAIR: an MRI marker for collateral circulation in acute stroke? Neurology 72:1134–1139CrossRefPubMedPubMedCentral

28.

Liu W, Yin Q, Yao L et al (2012) Decreased hyperintense vessels on FLAIR images after endovascular recanalization of symptomatic internal carotid artery occlusion. Eur J Radiol 81:1595–1600CrossRefPubMed

29.

Ebinger M, Kufner A, Galinovic I et al (2012) Fluid-attenuated inversion recovery images and stroke outcome after thrombolysis. Stroke 43:539–542CrossRefPubMed

30.

Karadeli HH, Giurgiutiu DV, Cloonan L et al (2016) FLAIR vascular hyperintensity is a surrogate of collateral flow and leukoaraiosis in patients with acute stroke due to proximal artery occlusion. J Neuroimaging 26:219–223CrossRefPubMed

31.

Kobayashi J, Uehara T, Toyoda K et al (2013) Clinical significance of fluid-attenuated inversion recovery vascular hyperintensities in transient ischemic attack. Stroke 44:1635–1640CrossRefPubMed

Titel: FLAIR vascular hyperintensity in acute stroke is associated with collateralization and functional outcome
verfasst von: Liang Jiang
Yu-Chen Chen
Hong Zhang
Mingyang Peng
Huiyou Chen
Wen Geng
Quan Xu
Xindao Yin
Yuehu Ma
Publikationsdatum: 14.02.2019
Verlag: Springer Berlin Heidelberg
Erschienen in: European Radiology / Ausgabe 9/2019
Print ISSN: 0938-7994
Elektronische ISSN: 1432-1084
DOI: https://doi.org/10.1007/s00330-019-06022-0

Neu im Fachgebiet Radiologie

23.04.2024 | Pankreaskarzinom | Nachrichten

Update Radiologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen

Springer Medizin

FLAIR vascular hyperintensity in acute stroke is associated with collateralization and functional outcome

Abstract

Purpose

Methods

Results

Conclusions

Key Points

Neu im Fachgebiet Radiologie

S3-Leitlinie zu Pankreaskrebs aktualisiert

Fünf Dinge, die im Kindernotfall besser zu unterlassen sind

„Nur wer sich gut aufgehoben fühlt, kann auch für Patientensicherheit sorgen“

Wie toxische Männlichkeit der Gesundheit von Männern schadet

Update Radiologie

Springer Medizin

Abstract

Purpose

Methods

Results

Conclusions

Key Points

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

Weitere Artikel der Ausgabe 9/2019

Clinical usefulness of right ventricular 3D area strain in the assessment of treatment effects of balloon pulmonary angioplasty in chronic thromboembolic pulmonary hypertension: comparison with 2D feature-tracking MRI

Comparison of CT angiography collaterals for predicting target perfusion profile and clinical outcome in patients with acute ischemic stroke

Percutaneous endovascular tissue sampling of endoluminal tumors using directional atherectomy

DXA-equivalent quantification of bone mineral density using dual-layer spectral CT scout scans

Optimal beam quality for chest flat panel detector system: realistic phantom study

Amount of fibroglandular tissue FGT and background parenchymal enhancement BPE in relation to breast cancer risk and false positives in a breast MRI screening program

Neu im Fachgebiet Radiologie

S3-Leitlinie zu Pankreaskrebs aktualisiert

Fünf Dinge, die im Kindernotfall besser zu unterlassen sind

„Nur wer sich gut aufgehoben fühlt, kann auch für Patientensicherheit sorgen“

Wie toxische Männlichkeit der Gesundheit von Männern schadet

Update Radiologie