Fluid-Attenuated Inversion Recovery Images and Stroke Outcome After Thrombolysis

Ebinger, Martin; Kufner, Anna; Galinović, Ivana; Brunecker, Peter; Malzahn, Uwe; Nolte, Christian H.; Endres, Matthias; Fiebach, Jochen B.

doi:10.1161/strokeaha.111.632026

Cited by 51 publications

(63 citation statements)

References 8 publications

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“…17 The presence of ischemic lesions on DWI or large artery occlusion is another predictor for recurrent stroke after TIA. [22][23][24][25][26] Although the association between FVH and poor outcome in patients with IS was demonstrated, 27,28 the association between FVH and recurrence of TIA or IS after TIA has been merely reported. 29 In the present study, Cox proportional hazard analysis showed that recurrence within 90 days after onset was associated with AOL and FVH, as well as coexistence of these 2.…”

Section: Discussionmentioning

confidence: 99%

Clinical Significance of Fluid-Attenuated Inversion Recovery Vascular Hyperintensities in Transient Ischemic Attack

Kobayashi

Uehara

Toyoda

et al. 2013

Stroke

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Background and Purpose-Fluid-attenuated inversion recovery vascular hyperintensity (FVH) is often identified in patients with acute ischemic stroke. The purpose of this study was to determine the clinical significance of FVH in patients with transient ischemic attack (TIA). Methods-Consecutive inpatients with TIA who underwent MRI within 24 hours of symptom onset were studied. Key Words: acute stroke ◼ atrial fibrillation ◼ fluid-attenuated inversion recovery ◼ magnetic resonance angiography ◼ transient ischemic attack

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Section: Discussionmentioning

confidence: 99%

Clinical Significance of Fluid-Attenuated Inversion Recovery Vascular Hyperintensities in Transient Ischemic Attack

Kobayashi

Uehara

Toyoda

et al. 2013

Stroke

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“…Недавно мы предложили альтернативную модель, основанную на выявлении несоответствия между гиперинтенсивными сигналами сосудов на изображениях в режиме с подав-лением сигнала свободной воды (FLAIR) и объемом зоны поражения на DWI для оценки наличия боль-шой зоны пенумбры [2]. Гиперинтенсивный сигнал от сосудов был зарегистрирован у 45-100% пациен-тов, перенесших инсульт с окклюзией внутричерепных артерий [3][4][5][6][7][8][9][10][11][12][13][14][15][16]. Этот сигнал соответствует медленно-му ретроградному кровотоку в лептоменингиальных коллатеральных сосудах [4], который поддерживает перфузию дистальнее зоны окклюзии до достижения реваскуляризации [17].…”

Section: ключевые слова: инфаркт (Infarction) магнитно-резонансная аunclassified

“…2 FVH have been reported in 45-100% of stroke patients with intracranial occlusion. [3][4][5][6][7][8][9][10][11][12][13][14][15][16] They represent slow retrograde flow in leptomeningeal collaterals, 4 which maintain some perfusion distal to the occlusion until revascularization. 17 The FVH-DWI mismatch focuses on FVH beyond the boundaries of the cortical DWI lesion, ignoring FVH adjacent to the DWI lesion.…”

mentioning

confidence: 99%

Fluid-Attenuated Inversion Recovery Vascular Hyperintensities–Diffusion-Weighted Imaging Mismatch Identifies Acute Stroke Patients Most Likely to Benefit From Recanalization

Legrand

Tisserand

Turc

et al. 2016

Stroke

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Background and Purpose-Fluid-attenuated inversion recovery vascular hyperintensities (FVH) beyond the boundaries of diffusion-weighted imaging (DWI) lesion (FVH-DWI mismatch) have been proposed as an alternative to perfusionweighted imaging (PWI)-DWI mismatch. We aimed to establish whether FVH-DWI mismatch can identify patients most likely to benefit from recanalization. Methods-FVH-DWI mismatch was assessed in 164 patients with proximal middle cerebral artery occlusion before intravenous thrombolysis. PWI-DWI mismatch (PWI Tmax>6sec /DWI>1.8) was assessed in the 104 patients with available PWI data. We tested the associations between 24-hours complete recanalization on magnetic resonance angiography and 3-month favorable outcome (modified Rankin Scale score ≤2), stratified on FVH-DWI (or PWI-DWI) status. Results-FVH-DWI mismatch was present in 121/164 (74%) patients and recanalization in 50/164 (30%) patients. The odds ratio for favorable outcome with recanalization was 16.2 (95% confidence interval, 5.7-46.5; P<0.0001) in patients with FVH-DWI mismatch and 2.6 (95% confidence interval, 0.6-12.1; P=0.22) in those without FVH-DWI mismatch (P=0.048 for interaction). Recanalization was associated with favorable outcome in patients with PWI-DWI mismatch (odds ratios, 9.9; 95% confidence interval, 3.1-31.3; P=0.0001) and in patients without PWI-DWI mismatch (odds ratios, 7.0; 95% confidence interval, 1.1-44.1; P=0.047), P=0.76 for interaction. Conclusion-The FVH-DWI mismatch may rapidly identify patients with proximal occlusion most likely to benefit from recanalization.

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“…1 Several studies suggest FHV to be indicative of hemodynamic stress, inadequate collateralization, and poor functional recovery. [2][3][4][5] Conversely, others attributed FHV to increased leptomeningeal collateralization and found an association with smaller lesions, slower infarct progression, and better prognosis. [6][7][8][9][10] The apparent contradiction of these studies may stem from the use of different methodologies and the diversity of populations studied, making the plethora of results challenging to analyze.…”

mentioning

confidence: 99%

Hyperintense Vessels on FLAIR: Hemodynamic Correlates and Response to Thrombolysis

Kufner¹,

Galinović

Ambrosi

et al. 2015

AJNR Am J Neuroradiol

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BACKGROUND AND PURPOSE:Hyperintense vessels on baseline FLAIR MR imaging of patients with ischemic stroke have been linked to leptomeningeal collateralization, yet the ability of these to maintain viable ischemic tissue remains unclear. We investigated whether hyperintense vessels on FLAIR are associated with the severity of hypoperfusion and response to thrombolysis in patients treated with intravenous tissue-plasminogen activator.

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Fluid-Attenuated Inversion Recovery Images and Stroke Outcome After Thrombolysis

Cited by 51 publications

References 8 publications

Clinical Significance of Fluid-Attenuated Inversion Recovery Vascular Hyperintensities in Transient Ischemic Attack

Clinical Significance of Fluid-Attenuated Inversion Recovery Vascular Hyperintensities in Transient Ischemic Attack

Fluid-Attenuated Inversion Recovery Vascular Hyperintensities–Diffusion-Weighted Imaging Mismatch Identifies Acute Stroke Patients Most Likely to Benefit From Recanalization

Hyperintense Vessels on FLAIR: Hemodynamic Correlates and Response to Thrombolysis

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