Clinical application of susceptibility-weighted imaging in the evaluation of leptomeningeal collateralization

Yang, Lijuan; Luo, Song

doi:10.1097/md.0000000000013345

Cited by 7 publications

(9 citation statements)

References 32 publications

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“…In addition, patients with PCV-SWI had a lower rate of good collateral status, as assessed by mCTA, than those without them. Our results are in good agreement with those of previous studies that compared various imaging methods, including digital subtraction angiography (DSA) [18], dynamic perfusion-weighted imaging (PWI) [20], and multiphase MRI angiography collateral mapping [26] and showed a correlation between a pronounced presence of PCV-SWI and poor leptomeningeal collaterals. However, one study that used FLAIR and postcontrast time-of-flight (TOF) MRI angiography to estimate collaterals reported that extensive PCV-SWIs were associated with better collateral flow [19].…”

Section: Discussionsupporting

confidence: 92%

“…Our study showed that the presence of extensive PCV–SWI was inversely correlated with leptomeningeal collaterals on mCTA. This result supports the hypothesis that the extent of PCV–SWI can quantitatively reflect leptomeningeal collaterals [ 20 ]. In addition, patients with PCV–SWI had a lower rate of good collateral status, as assessed by mCTA, than those without them.…”

Section: Discussionsupporting

confidence: 89%

“…In clinical practice, susceptibility-weighted imaging (SWI) is a useful imaging tool for detecting an intracerebral hemorrhage, intra-arterial thrombus, microbleed, and hemorrhagic transformation of acute stroke [ 17 ]. Previous studies have shown that the extent of prominent cortical vessels observed on SWI (PCV–SWI), which identify the cortical pia mater, reflects the extent of hypoperfusion and is correlated with leptomeningeal collaterals in AIS [ 18 , 19 , 20 ]. Published studies have evaluated the value of PCV–SWI for assessing the status of collaterals and predicting outcomes in AIS; however, the clinical application of PCV–SWI for evaluating leptomeningeal collaterals prior to recanalization therapy remains inconclusive, since these studies generally have different study designs, patient characteristics, collateral-estimating imaging methods, and small sample sizes [ 20 , 21 , 22 , 23 , 24 , 25 , 26 ].…”

Section: Introductionmentioning

confidence: 99%

“…Previous studies have shown that the extent of prominent cortical vessels observed on SWI (PCV–SWI), which identify the cortical pia mater, reflects the extent of hypoperfusion and is correlated with leptomeningeal collaterals in AIS [ 18 , 19 , 20 ]. Published studies have evaluated the value of PCV–SWI for assessing the status of collaterals and predicting outcomes in AIS; however, the clinical application of PCV–SWI for evaluating leptomeningeal collaterals prior to recanalization therapy remains inconclusive, since these studies generally have different study designs, patient characteristics, collateral-estimating imaging methods, and small sample sizes [ 20 , 21 , 22 , 23 , 24 , 25 , 26 ]. In particular, it is still unclear whether evaluating PCV–SWI can be considered as an alternative to mCTA for assessing leptomeningeal collaterals and predicting the outcomes of patients treated with recanalization therapy.…”

Section: Introductionmentioning

confidence: 99%

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Clinical Implications of Prominent Cortical Vessels on Susceptibility-Weighted Imaging in Acute Ischemic Stroke Patients Treated with Recanalization Therapy

Lee

2022

Brain Sciences

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Prominent cortical vessels on susceptibility-weighted imaging (PCV–SWI) correlate with poor leptomeningeal collaterals. However, little is known about PCV–SWI in recanalization therapy-treated patients with anterior circulation large vessel occlusions (LVO). We investigated PCV–SWI-based assessment of leptomeningeal collaterals and outcome predictions in 100 such patients in an observational study. We assessed PCV–SWI using the Alberta Stroke Program Early CT Score and evaluated leptomeningeal collaterals on multiphase CT angiography (mCTA). Predictive abilities were analyzed using multivariable logistic regression and area of receiver operating curves (AUCs). The extent of PCV–SWI correlated with leptomeningeal collaterals on mCTA (Spearman test, r = 0.77; p < 0.001); their presence was associated with worse functional outcomes and a lower successful recanalization rate (adjusted odds ratios = 0.24 and 0.23, 95% CIs = 0.08–0.65 and 0.08–0.65, respectively). The presence of PCV–SWI predicted outcomes better than good collaterals on mCTA did (C-statistic = 0.84 vs. 0.80; 3-month modified Rankin Scale (mRS) 0–2 = 0.75 vs. 0.67 for successful recanalization). Comparison of AUCs showed that they had similar abilities for predicting outcomes (p = 0.68 for 3-month mRS 0–2; p = 0.23 for successful recanalization). These results suggest that PCV–SWI is a useful feature for assessing leptomeningeal collaterals in acute ischemic stroke patients with anterior circulation LVO and predicting outcomes after recanalization therapy.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionsupporting

confidence: 89%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Clinical Implications of Prominent Cortical Vessels on Susceptibility-Weighted Imaging in Acute Ischemic Stroke Patients Treated with Recanalization Therapy

Lee

2022

Brain Sciences

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“… 19 Several studies have shown that in patients with acute ischemic stroke, the range of the PVS on SWI was closely related to the range of MTT prolongation on PWI. 20 – 22 The PVS provides perfusion information comparable with the MTT and reflects the range of hypoperfusion.…”

Section: Discussionmentioning

confidence: 99%

Susceptibility-diffusion mismatch correlated with leptomeningeal collateralization in large vessel occlusion stroke

Jiang

Zhang²,

Pang

et al. 2021

J Int Med Res

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Objective To investigate the relationship between asymmetric prominent hypointense vessels (prominent vessel sign, PVS) on susceptibility-weighted imaging (SWI) and leptomeningeal collateralization in patients with acute ischemic stroke due to large vessel occlusion. Methods We retrospectively enrolled patients with M1 segment occlusion of the middle cerebral artery who underwent emergency magnetic resonance imaging and digital subtraction angiography within 24 hours from stroke onset. The extent of PVS on SWI was assessed using the Alberta Stroke Program Early CT Score (ASPECTS). Leptomeningeal collateralization on digital subtraction angiography images was assessed using the American Society of Interventional and Therapeutic Neuroradiology/Society of Interventional Radiology (ASITN/SIR) scale. Spearman’s rank correlation test was performed to explore the correlation of ASITN/SIR scores with SWI-ASPECTS and SWI-diffusion-weighted imaging (DWI) mismatch scores. Results Thirty-five patients were enrolled. There was no significant correlation between SWI-ASPECTS and ASITN/SIR scores. However, SWI-DWI mismatch scores were positively correlated with ASITN/SIR scores. Conclusion The range of PVS on SWI did not closely reflect the collateral status, while the range of SWI-DWI mismatch was significantly correlated with the leptomeningeal collateralization. In patients with acute anterior circulation stroke due to large vessel occlusion, larger SWI-DWI mismatch was associated with better leptomeningeal collaterals.

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Simultaneous time‐of‐flight MR angiography and quantitative susceptibility mapping with key time‐of‐flight features

De,

Grenier,

Wilman

2023

NMR in Biomedicine

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A technique for combined time‐of‐flight (TOF) MR angiography (MRA) and quantitative susceptibility mapping (QSM) was developed with key features of standard three‐dimensional (3D) TOF acquisitions, including multiple overlapping thin slab acquisition (MOTSA), ramped RF excitation, and venous saturation. The developed triple‐echo 3D TOF‐QSM sequence enabled TOF‐MRA, susceptibility‐weighted imaging (SWI), QSM, and R2* mapping. The effects of ramped RF, resolution, flip angle, venous saturation, and MOTSA were studied on QSM. Six volunteers were scanned at 3 T with the developed sequence, conventional TOF‐MRA, and conventional SWI. Quantitative comparison of susceptibility values on QSM and normalized arterial and venous vessel‐to‐background contrasts on TOF and SWI were performed. The ramped RF excitation created an inherent phase variation in the raw phase. A generic correction factor was computed to remove the phase variation to obtain QSM without artifacts from the TOF‐QSM sequence. No statistically significant difference was observed between the developed and standard QSM sequence for susceptibility values. However, maintaining standard TOF features led to compromises in signal‐to‐noise ratio for QSM and SWI, arising from the use of MOTSA rather than one large 3D slab, higher TOF spatial resolution, increased TOF background suppression due to larger flip angles, and reduced venous signal from venous saturation. In terms of vessel contrast, veins showed higher normalized contrast on SWI derived from TOF‐QSM than the standard SWI sequence. While fast flowing arteries had reduced contrast compared with standard TOF‐MRA, no statistical difference was observed for slow flowing arteries. Arterial contrast differences largely arise from the longer TR used in TOF‐QSM over standard TOF‐MRA to accommodate additional later echoes for SWI. In conclusion, although the sequence has a longer TR and slightly lower arterial contrast, provided an adequate correction is made for ramped RF excitation effects on phase, QSM may be performed from a multiecho sequence that includes all key TOF features, thus enabling simultaneous TOF‐MRA, SWI, QSM, and R2* map computation.

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Clinical application of susceptibility-weighted imaging in the evaluation of leptomeningeal collateralization

Cited by 7 publications

References 32 publications

Clinical Implications of Prominent Cortical Vessels on Susceptibility-Weighted Imaging in Acute Ischemic Stroke Patients Treated with Recanalization Therapy

Clinical Implications of Prominent Cortical Vessels on Susceptibility-Weighted Imaging in Acute Ischemic Stroke Patients Treated with Recanalization Therapy

Susceptibility-diffusion mismatch correlated with leptomeningeal collateralization in large vessel occlusion stroke

Simultaneous time‐of‐flight MR angiography and quantitative susceptibility mapping with key time‐of‐flight features

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