Progression of Middle Cerebral Artery Susceptibility Sign on T2<sup>*</sup>-Weighted Images: Its Effect on Recanalization and Clinical Outcome After Thrombolysis

Kim, Ho Sung; Lee, Deok Hee; Choi, Choong Gon; Kim, Sang Joon; Suh, Dae Chul

doi:10.2214/ajr.05.0447

Cited by 31 publications

(40 citation statements)

References 33 publications

(22 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The recanalization rate of thrombectomy is also influenced by those factors (22)(23)(24). Although SWI can more sensitively detect acute MCA occlusion than conventional GRE technique, it also shows great susceptibility artifact in area of the skull base.…”

Section: Discussionmentioning

confidence: 99%

Susceptibility Vessel Sign for the Detection of Hyperacute MCA Occlusion: Evaluation with Susceptibility-weighted MR Imaging

Lee

Cho

Choi

et al. 2016

Investig Magn Reson Imaging

View full text Add to dashboard Cite

Original ArticlePurpose: Susceptibility vessel sign (SVS) on gradient echo image, which is caused by MR signal loss due to arterial thrombosis, has been reported in acute middle cerebral artery (MCA) infarction. However, the reported sensitivity and diagnostic accuracy of SVS have been variable. Susceptibility-weighted imaging (SWI) is a newly developed MR sequence. Recent studies have found that SWI may be useful in the field of cerebrovascular diseases, especially for detecting the presence of prominent veins, microbleeds and the SVS. The purpose of this study was to evaluate the diagnostic values of SWI for the detection of hyperacute MCA occlusion. Materials and Methods: Sixty-nine patients (37 males, 32 females; 46-89 years old [mean, 69.1]) with acute stroke involving the MCA territory underwent MR imaging within 6 hours after the symptom onset. MR examination included T2, FLAIR (fluid-attenuated inversion recovery), DWI, SWI, PWI (perfusion-weighted imaging), contrast-enhanced MR angiography (MRA) and contrast-enhanced T1. Of these patients, 28 patients also underwent digital subtraction angiography (DSA) within 2 hours after MR examination. Presence or absence of SVS on SWI was assessed without knowledge of clinical, DSA and other MR imaging findings. Results: On MRA or DSA, 34 patients (49.3%) showed MCA occlusion. Of these patients, SVS was detected in 30 (88.2%) on SWI. The sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy of SWI were 88.2%, 97.1%, 96.8%, 89.5% and 92.8%, respectively. Conclusion: SWI was sensitive, specific and accurate for the detection of hyperacute MCA occlusion.

show abstract

Section: Discussionmentioning

confidence: 99%

Susceptibility Vessel Sign for the Detection of Hyperacute MCA Occlusion: Evaluation with Susceptibility-weighted MR Imaging

Lee

Cho

Choi

et al. 2016

Investig Magn Reson Imaging

View full text Add to dashboard Cite

show abstract

“…[7][8][9] The prognostic value of SVS for arterial recanalization after intravenous (IV) thrombolysis and functional outcome remains debated, although some studies 11,12 demonstrated an association with low recanalization rate, others did not. 9,[13][14][15] These discrepancies may be because of the lack of assessment of the amount of clot burden. For this purpose, a CT angiography (CTA)-based scale, denominated clot burden score (CBS), has been proposed.…”

mentioning

confidence: 99%

Clot Burden Score on Admission T2*-MRI Predicts Recanalization in Acute Stroke

Legrand

Naggara

Turc

et al. 2013

Stroke

View full text Add to dashboard Cite

Background and Purpose-To propose a T2*-MR adaptation of the computed tomography angiography-clot burden score (CBS), and assess its value as predictor of 24-hour recanalization and clinical outcome in anterior circulation stroke treated by intravenous thrombolysis ≤4.5 hours from onset. Methods-Two independent observers retrospectively analyzed pretreatment T2* images for evaluation of clot burden, using a 10-point scale T2*-CBS. Three points are subtracted for susceptibility vessel sign in the supraclinoid internal carotid artery, 2 points each for susceptibility vessel sign in the proximal and distal part of middle cerebral artery, and 1 point each for susceptibility vessel sign in middle cerebral artery branches (with a maximum of 2 points) and for susceptibility vessel sign in anterior cerebral artery. Associations with 24-hour recanalization and favorable outcome (3-month modified Rankin Scale score, ≤2) were assessed in multivariate analyses. Results-We analyzed 184 consecutive patients (mean age, 67 years) with median (interquartile range) admission NationalInstitutes of Health Stroke Scale score and onset-to-treatment time of 15 (9-19) and 151 (120-185) minutes, respectively. The intraclass correlation for T2*-CBS between observers was 0.97 (95% confidence interval, 0.97-0.98). In multivariate analyses, T2*-CBS >6 was significantly associated with 24-hour recanalization (adjusted odds ratio, 5.1 [1.9-13.5]; P=0.001) or with favorable outcome (adjusted odds ratio, 4.2 [1.7-10.8]; P=0.003). Conclusions-T2*-CBS, a new reproducible semiquantitative score adapted from the computed tomography angiography-CBS,is associated with 24-hour recanalization and 3-month outcome after intravenous thrombolysis. This score needs external validation and could be useful to identify poor responders to intravenous thrombolysis.

show abstract

“…According to many studies, SVS on GRE-T2* represents a thrombus in an artery analogous to the CT hyperattenuated artery sign. 13,14 We have also depicted SVS on GRE-T2* at 3T in all 20 patients with acute stroke. Hermier 8 et al…”

Section: Discussionmentioning

confidence: 99%

Acute Ischemic Infarction Defined by a Region of Multiple Hypointense Vessels on Gradient-Echo T2* MR Imaging at 3T

Kaya

Di̇nçer²,

Yıldız³

et al. 2009

AJNR Am J Neuroradiol

View full text Add to dashboard Cite

BACKGROUND AND PURPOSE:During the hyperacute phase of stroke, multiple hypointense vessels were identified specifically in the ischemic territory on gradient-echo T2*-weighted MR images (GRE-T2* WI) at 3T. The area was named a "region of multiple hypointense vessels (RMHV)." The aim of this study was to assess the usefulness of RMHV for the diagnosis of acute ischemic stroke (AIS) and to establish the relationship of this finding to other MR imaging studies.

show abstract

Progression of Middle Cerebral Artery Susceptibility Sign on T2^*-Weighted Images: Its Effect on Recanalization and Clinical Outcome After Thrombolysis

Cited by 31 publications

References 33 publications

Susceptibility Vessel Sign for the Detection of Hyperacute MCA Occlusion: Evaluation with Susceptibility-weighted MR Imaging

Susceptibility Vessel Sign for the Detection of Hyperacute MCA Occlusion: Evaluation with Susceptibility-weighted MR Imaging

Clot Burden Score on Admission T2*-MRI Predicts Recanalization in Acute Stroke

Acute Ischemic Infarction Defined by a Region of Multiple Hypointense Vessels on Gradient-Echo T2* MR Imaging at 3T

Contact Info

Product

Resources

About

Progression of Middle Cerebral Artery Susceptibility Sign on T2*-Weighted Images: Its Effect on Recanalization and Clinical Outcome After Thrombolysis

Cited by 31 publications

References 33 publications

Susceptibility Vessel Sign for the Detection of Hyperacute MCA Occlusion: Evaluation with Susceptibility-weighted MR Imaging

Susceptibility Vessel Sign for the Detection of Hyperacute MCA Occlusion: Evaluation with Susceptibility-weighted MR Imaging

Clot Burden Score on Admission T2*-MRI Predicts Recanalization in Acute Stroke

Acute Ischemic Infarction Defined by a Region of Multiple Hypointense Vessels on Gradient-Echo T2* MR Imaging at 3T

Contact Info

Product

Resources

About

Progression of Middle Cerebral Artery Susceptibility Sign on T2^*-Weighted Images: Its Effect on Recanalization and Clinical Outcome After Thrombolysis