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Leptomeningeal collateralization in acute ischemic stroke: Impact on prominent cortical veins in susceptibility-weighted imaging

Authors :
Marwan El-Koussy
Jan Gralla
Kety Hsieh
Frauke Kellner-Weldon
Pascal P. Gratz
Gerhard Schroth
Simon Jung
Rajeev Kumar Verma
Pasquale Mordasini
Adrian Schankath
Christoph Zubler
Source :
European Journal of Radiology. 83:1448-1454
Publication Year :
2014
Publisher :
Elsevier BV, 2014.

Abstract

BACKGROUND The extent of hypoperfusion is an important prognostic factor in acute ischemic stroke. Previous studies have postulated that the extent of prominent cortical veins (PCV) on susceptibility-weighted imaging (SWI) reflects the extent of hypoperfusion. Our aim was to investigate, whether there is an association between PCV and the grade of leptomeningeal arterial collateralization in acute ischemic stroke. In addition, we analyzed the correlation between SWI and perfusion-MRI findings. METHODS 33 patients with acute ischemic stroke due to a thromboembolic M1-segment occlusion underwent MRI followed by digital subtraction angiography (DSA) and were subdivided into two groups with very good to good and moderate to no leptomeningeal collaterals according to the DSA. The extent of PCV on SWI, diffusion restriction (DR) on diffusion-weighted imaging (DWI) and prolonged mean transit time (MTT) on perfusion-imaging were graded according to the Alberta Stroke Program Early CT Score (ASPECTS). The National Institutes of Health Stroke Scale (NIHSS) scores at admission and the time between symptom onset and MRI were documented. RESULTS 20 patients showed very good to good and 13 patients poor to no collateralization. PCV-ASPECTS was significantly higher for cases with good leptomeningeal collaterals versus those with poor leptomeningeal collaterals (mean 4.1 versus 2.69; p=0.039). MTT-ASPECTS was significantly lower than PCV-ASPECTS in all 33 patients (mean 1.0 versus 3.5; p

Details

ISSN :
0720048X
Volume :
83
Database :
OpenAIRE
Journal :
European Journal of Radiology
Accession number :
edsair.doi.dedup.....39122d6ba30dd94452ab4e776eb6bc6d
Full Text :
https://doi.org/10.1016/j.ejrad.2014.05.001