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Fluid-Attenuated Inversion Recovery Vascular Hyperintensity Topography, Novel Imaging Marker for Revascularization in Middle Cerebral Artery Occlusion.
- Source :
-
Stroke [Stroke] 2016 Nov; Vol. 47 (11), pp. 2763-2769. Date of Electronic Publication: 2016 Sep 22. - Publication Year :
- 2016
-
Abstract
- Background and Purpose: In acute arterial occlusion, fluid-attenuated inversion recovery vascular hyperintensity (FVH) has been linked to slow flow in leptomeningeal collaterals and cerebral hypoperfusion, but the impact on clinical outcome is still controversial. In this study, we aimed to investigate the association between FVH topography or FVH-Alberta Stroke Program Early CT Score (ASPECTS) pattern and outcome in acute M1-middle cerebral artery occlusion patients with endovascular treatment.<br />Methods: We included acute M1-middle cerebral artery occlusion patients treated with endovascular therapy (ET). All patients had diffusion-weighted imaging (DWI) and fluid-attenuated inversion recovery before ET. Distal FVH-ASPECTS was evaluated according to distal middle cerebral artery-ASPECT area (M1-M6) and acute DWI lesion was also reviewed. The presence of FVH inside and outside DWI-positive lesions was separately analyzed. Clinical outcome after ET was analyzed with respect to different distal FVH-ASPECTS topography.<br />Results: Among 101 patients who met inclusion criteria for the study, mean age was 66.2±17.8 years and median National Institutes of Health Stroke Scale was 17.0 (interquartile range, 12.0-21.0). FVH-ASPECTS measured outside of the DWI lesion was significantly higher in patients with good outcome (modified Rankin Scale [mRS] score of 0-2; 8.0 versus 4.0, P<0.001). Logistic regression demonstrated that FVH-ASPECTS outside of the DWI lesion was independently associated with clinical outcome of these patients (odds ratio, 1.3; 95% confidence interval, 1.06-1.68; P=0.013). FVH-ASPECTS inside the DWI lesion was associated with hemorrhagic transformation (odds ratio, 1.3; 95% confidence interval, 1.04-1.51; P=0.019).<br />Conclusions: Higher FVH-ASPECTS measured outside the DWI lesion is associated with good clinical outcomes in patients undergoing ET. FVH-ASPECTS measured inside the DWI lesion was predictive of hemorrhagic transformation. The FVH pattern, not number, can serve as an imaging selection marker for ET in acute middle cerebral artery occlusion.<br /> (© 2016 American Heart Association, Inc.)
- Subjects :
- Adult
Aged
Aged, 80 and over
Biomarkers
Female
Humans
Infarction, Middle Cerebral Artery drug therapy
Male
Middle Aged
Cerebral Angiography methods
Cerebrovascular Circulation physiology
Infarction, Middle Cerebral Artery diagnostic imaging
Infarction, Middle Cerebral Artery therapy
Magnetic Resonance Imaging methods
Mechanical Thrombolysis methods
Outcome Assessment, Health Care
Severity of Illness Index
Thrombolytic Therapy methods
Subjects
Details
- Language :
- English
- ISSN :
- 1524-4628
- Volume :
- 47
- Issue :
- 11
- Database :
- MEDLINE
- Journal :
- Stroke
- Publication Type :
- Academic Journal
- Accession number :
- 27659851
- Full Text :
- https://doi.org/10.1161/STROKEAHA.116.013953