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Neuroradiology

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01.06.2019 | Diagnostic Neuroradiology

Topography of the hyperintense vessel sign on fluid-attenuated inversion recovery represents cerebral hemodynamics in middle cerebral artery occlusion: a CT perfusion study

verfasst von: Xianjun Huang, Xiaolei Shi, Qian Yang, Yunfeng Zhou, Xiangjun Xu, Junfeng Xu, Xianhui Ding, Zhiming Zhou

Erschienen in: Neuroradiology | Ausgabe 10/2019

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Abstract

Purpose

Whether the topography of fluid-attenuated inversion recovery hyperintense vessel sign (FHVs) can serve as a measure of cerebral hemodynamic stress remains unclear. We hypothesized that FHVs topography represents different cerebral hemodynamic status, as assessed by CT perfusion (CTP).

Methods

We retrospectively reviewed 75 patients with acute middle cerebral artery (MCA) occlusion who underwent MR imaging and CTP. The FHVs topography included FHVs inside the diffusion-weighted imaging (DWI) lesion (FHVs in-group), FHVs outside the DWI lesion (FHVs out-group), and FHVs distributed inside and outside the DWI lesion (FHVs all-group). FHVs scores were assessed by the Alberta stroke program early computed tomography score (ASPECT) territories. Cerebral hemodynamic status was evaluated by relative (r) CTP parameters. Cerebral hemodynamic status was analyzed with respect to different FHVs topographies and FHVs scores.

Results

Hemodynamic impairment was present in all patients, with the following mean rCTP parameters: rCBF, 0.77 ± 0.23; rCBV, 1.06 ± 0.32; and rMTT, 1.52 ± 0.60. Comparison of the rCTP parameters among the three groups, rCBF and rCBV (rCBF, P < 0.001; rCBV, P < 0.001) in the FHVs out-group and the FHVs all-group (rCBF, P = 0.001; rCBV, P < 0.001), were significantly higher than that in the FHVs in-group. Similarly, CTA collateral grade in the FHVs in-group was significantly lower than those in the FHVs out-group and FHVs all-group (P < 0.001). No significant difference was found in rCTP parameters between different FHVs scores.

Conclusion

The different FHVs topographies represented different cerebral hemodynamic status. FHVs topography may serve as a surrogate for patient selection for reperfusion therapy whenever perfusion data are unavailable.

Shuaib A, Butcher K, Mohammad AA, Saqqur M, Liebeskind DS (2011) Collateral blood vessels in acute ischaemic stroke: a potential therapeutic target. Lancet Neurol 10:909–921CrossRefPubMed

Liebeskind DS (2003) Collateral circulation. Stroke 34:2279–2284CrossRefPubMed

Menon BK, d'Esterre CD, Qazi EM, Almekhlafi M, Hahn L, Demchuk AM, Goyal M (2015) Multiphase CT angiography: a new tool for the imaging triage of patients with acute ischemic stroke. Radiology 275:510–520CrossRefPubMed

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

Kamran S, Bates V, Bakshi R, Wright P, Kinkel W, Miletich R (2000) Significance of hyperintense vessels on FLAIR MRI in acute stroke. Neurology 55:265–269CrossRefPubMed

Yoshioka K, Ishibashi S, Shiraishi A, Yokota T, Mizusawa H (2013) Distal hyperintense vessels on FLAIR images predict large-artery stenosis in patients with transient ischemic attack. Neuroradiology 55:165–169CrossRefPubMed

Huang X, Liu W, Zhu W, Ni G, Sun W, Ma M, Zhou Z, Wang Q, Xu G, Liu X (2012) Distal hyperintense vessels on FLAIR: a prognostic indicator of acute ischemic stroke. Eur Neurol 68:214–220CrossRefPubMed

Sanossian N, Saver JL, Alger JR, Kim D, Duckwiler GR, Jahan R, Vinuela F, Ovbiagele B, Liebeskind DS (2009) Angiography reveals that fluid-attenuated inversion recovery vascular hyperintensities are due to slow flow, not thrombus. AJNR Am J Neuroradiol 30:564–568CrossRefPubMed

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 26:618–624PubMed

10.

Liu W, Xu G, Yue X, Wang X, Ma M, Zhang R, Wang H, Zhou C, Liu X (2011) Hyperintense vessels on FLAIR: a useful non-invasive method for assessing intracerebral collaterals. Eur J Radiol 80:786–791CrossRefPubMed

11.

Hohenhaus M, Schmidt WU, Brunecker P, Xu C, Hotter B, Rozanski M, Fiebach JB, Jungehulsing GJ (2012) FLAIR vascular hyperintensities in acute ICA and MCA infarction: a marker for mismatch and stroke severity? Cerebrovasc Dis 34:63–69CrossRefPubMed

12.

Nam KW, Kim CK, Kim TJ, Oh K, Han MK, Ko SB, Yoon BW (2018) FLAIR vascular hyperintensities predict early ischemic recurrence in TIA. Neurology 90:e738–e744CrossRefPubMed

13.

Kufner A, Galinovic I, Ambrosi V, Nolte CH, Endres M, Fiebach JB, Ebinger M (2015) Hyperintense vessels on FLAIR: hemodynamic correlates and response to thrombolysis. AJNR Am J Neuroradiol 36:1426–1430CrossRefPubMed

14.

Mahdjoub E, Turc G, Legrand L, Benzakoun J, Edjlali M, Seners P, Charron S, Ben Hassen W, Naggara O, Meder JF, Mas JL, Baron JC, Oppenheim C (2018) Do fluid-attenuated inversion recovery vascular hyperintensities represent good collaterals before reperfusion therapy? AJNR Am J Neuroradiol 39:77–83CrossRefPubMed

15.

Sakuta K, Saji N, Aoki J, Sakamoto Y, Shibazaki K, Iguchi Y, Kimura K (2016) Decrease of hyperintense vessels on fluid-attenuated inversion recovery predicts good outcome in t-PA patients. Cerebrovasc Dis 41:211–218CrossRefPubMed

16.

Liu D, Scalzo F, Rao NM, Hinman JD, Kim D, Ali LK, Saver JL, Sun W, Dai Q, Liu X, Liebeskind DS (2016) Fluid-attenuated inversion recovery vascular hyperintensity topography, novel imaging marker for revascularization in middle cerebral artery occlusion. Stroke 47:2763–2769CrossRefPubMedPubMedCentral

17.

Perez de la Ossa N, Hernandez-Perez M, Domenech S, Cuadras P, Massuet A, Millan M, Gomis M, Lopez-Cancio E, Dorado L, Davalos A (2012) Hyperintensity of distal vessels on FLAIR is associated with slow progression of the infarction in acute ischemic stroke. Cerebrovasc Dis 34:376–384CrossRefPubMed

18.

Legrand L, Tisserand M, Turc G, Naggara O, Edjlali M, Mellerio C, Mas JL, Meder JF, Baron JC, Oppenheim C (2015) Do FLAIR vascular hyperintensities beyond the DWI lesion represent the ischemic penumbra? AJNR Am J Neuroradiol 36:269–274CrossRefPubMed

19.

Kameda K, Uno J, Otsuji R, Ren N, Nagaoka S, Maeda K, Ikai Y, Gi H (2018) Optimal thresholds for ischemic penumbra predicted by computed tomography perfusion in patients with acute ischemic stroke treated with mechanical thrombectomy. J Neurointerv Surg 10:279–284CrossRefPubMed

20.

Arenillas JF, Cortijo E, Garcia-Bermejo P, Levy EI, Jahan R, Goyal M, Saver JL, Albers GW (2017) Relative cerebral blood volume is associated with collateral status and infarct growth in stroke patients in SWIFT PRIME. J Cereb Blood Flow Metab 38:1839–1847CrossRefPubMedPubMedCentral

21.

Tan IY, Demchuk AM, Hopyan J, Zhang L, Gladstone D, Wong K, Martin M, Symons SP, Fox AJ, Aviv RI (2009) CT angiography clot burden score and collateral score: correlation with clinical and radiologic outcomes in acute middle cerebral artery infarct. AJNR Am J Neuroradiol 30:525–531CrossRefPubMed

22.

Vagal A, Aviv R, Sucharew H, Reddy M, Hou Q, Michel P, Jovin T, Tomsick T, Wintermark M, Khatri P (2018) Collateral clock is more important than time clock for tissue fate. Stroke 49:2102–2107CrossRefPubMedPubMedCentral

23.

Wolf R (2001) Intraarterial signal on fluid-attenuated inversion recovery images: a measure of hemodynamic stress? AJNR Am J Neuroradiol 22:1015–1016PubMed

24.

Liebeskind DS (2005) Location, location, location: angiography discerns early MR imaging vessel signs due to proximal arterial occlusion and distal collateral flow. AJNR Am J Neuroradiol 26:2432–2434PubMed

25.

Haussen DC, Koch S, Saraf-Lavi E, Shang T, Dharmadhikari S, Yavagal DR (2013) FLAIR distal hyperintense vessels as a marker of perfusion-diffusion mismatch in acute stroke. J Neuroimaging 23:397–400CrossRefPubMed

26.

Jickling GC, Liu D, Stamova B, Ander BP, Zhan X, Lu A, Sharp FR (2014) Hemorrhagic transformation after ischemic stroke in animals and humans. J Cereb Blood Flow Metab 34:185–199CrossRefPubMed

27.

Bang OY, Saver JL, Kim SJ, Kim GM, Chung CS, Ovbiagele B, Lee KH, Liebeskind DS (2011) Collateral flow averts hemorrhagic transformation after endovascular therapy for acute ischemic stroke. Stroke 42:2235–2239CrossRefPubMed

28.

Nave AH, Kufner A, Bücke P, Siebert E, Kliesch S, Grittner U, Bӓzner H, Liebig T, Endres M, Fiebach JB, Nolte CH, Ebinger M, Henkes H (2018) Hyperintense vessels, collateralization, and functional outcome in patients with stroke receiving endovascular treatment. Stroke 49:675–681CrossRefPubMed

29.

Liebeskind DS, Kim D, Starkman S, Changizi K, Ohanian AG, Jahan R, Vinuela F (2010) Collateral failure? Late mechanical thrombectomy after failed intravenous thrombolysis. J Neuroimaging 20:78–82CrossRefPubMedPubMedCentral

30.

Ahn SJ, Suh SH, Lee KY, Kim JH, Seo KD, Lee S (2015) Hyperintense vessels on T2-PROPELLER-FLAIR in patients with acute MCA stroke: prediction of arterial stenosis and perfusion abnormality. AJNR Am J Neuroradiol 36:2042–2047CrossRefPubMed

31.

Ahn SJ, Lee KY, Ahn SS, Hwal S, Kim B, Lee SK (2016) Can FLAIR hyperintense vessel (FHV) signs be influenced by varying MR parameters and flow velocities? A flow phantom analysis. Acta Radiol 57:580–586CrossRefPubMed

32.

Lee SH, Seo KD, Kim JH, Suh SH, Ahn SJ, Lee KY (2016) Correlation between hyperintense vessels on FLAIR imaging and arterial circulation time on cerebral angiography. Magn Reson Med Sci 15:105–110CrossRefPubMed

Titel: Topography of the hyperintense vessel sign on fluid-attenuated inversion recovery represents cerebral hemodynamics in middle cerebral artery occlusion: a CT perfusion study
verfasst von: Xianjun Huang
Xiaolei Shi
Qian Yang
Yunfeng Zhou
Xiangjun Xu
Junfeng Xu
Xianhui Ding
Zhiming Zhou
Publikationsdatum: 01.06.2019
Verlag: Springer Berlin Heidelberg
Erschienen in: Neuroradiology / Ausgabe 10/2019
Print ISSN: 0028-3940
Elektronische ISSN: 1432-1920
DOI: https://doi.org/10.1007/s00234-019-02231-y

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