The different clinical value of susceptibility vessel sign in acute ischemic stroke patients under different interventional therapy: A systematic review and meta-analysis

Liu, Mingsu; Li, Lin; Li, Guangqin

doi:10.1016/j.jocn.2019.01.002

Cited by 18 publications

(25 citation statements)

References 46 publications

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“…11 The SVS sign was more frequently observed in patients with erythrocyte-dominant clots and stroke aetiology of cardiogenic embolus (CE), rather than fibrin-dominant clot and patients with large artery atherosclerosis (LAA). 12 13 This association was further supported by a systematic review by Liu M. et al 2…”

Section: Introductionmentioning

confidence: 56%

“…Despite previous study which reported the presence of SVS as significant predictor for stroke subtype in particularly of cardioembolic origin 2, the presence of SVS as a predictor for recanalization in response to IVT or EVT in AIS patients still remains debatable. It was known that the presence of an SVS in thrombi is related to the composition of a clot.…”

Section: Discussionmentioning

confidence: 91%

“…In recent years, there have been a multitude of studies which investigated the association between gradient-recalled echo (GRE)/susceptibility-weighted imaging (SWI) magnetic resonance imaging (MRI) sequences as a prognostication test for recanalization rate and clinical outcome. 1 2…”

Section: Introductionmentioning

confidence: 99%

“…Despite the abundance of published studies which evaluated the prognostic value of these two signs on GRE/SWI, the significance of it in determining recanalization rate and clinical outcomes remains debatable. 1 2 Considering the uncertainty, this systematic review was conducted to assess all current evidences on the prognostic value of SVS and PHVS in patients with acute ischemic stroke, and their recanalization status and clinical outcomes.…”

Section: Introductionmentioning

confidence: 99%

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Susceptibility vessel sign as a predictor for recanalization and clinical outcome in acute ischaemic stroke: A Systematic Review and Meta-analysis

Tang

Sen

2021

Preprint

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T2*-weighted MRI using GRE and SWI sequences can potentially prognosticate the recanalization rate and clinical outcomes in patients with acute ischaemic stroke, using susceptibility vessel sign (SVS) and prominent hypointense vessel sign (PHVS).A literature search on PubMed, EMBASE databases and other sources from inception up to 01 February 2020 was conducted. 15 studies which reported SVS and PHVS were included in qualitative synthesis. 9 studies on SVS were included in quantitative synthesis i.e. meta-analysis.Meta-analysis did not show any significant difference in the recanalization rate between SVS (+) group and SVS (-) group (RR = 0.95, 95% CI = 0.87–1.05, p = 0.33). Treatment subgroup analysis (intravenous thrombolysis, IVT- or mechanical thrombectomy, MT-only) does not show significant association between the SVS and IVT-only (RR = 0.73, 95% CI = 0.51-1.05, P=0.09); or MT-only groups (RR = 0.99, 95% CI = 0.90-1.09, P=0.90). No significant association between poor clinical outcome at 3 months and presence of SVS (RR = 1.42, 95% CI = 0.79–2.57, p = 0.24). Treatment subgroup analysis revealed significant association of the SVS and poor clinical outcome at 3 months in the MT-only (RR = 0.67, 95% CI = 0.55–0.82, p = 0.0001) or no thrombolytic treatment (RR = 2.83, 95% CI = 1.69-4.75, p < 0.0001).In conclusion, there is a significant association between the presence of SVS and poor clinical outcome in patients who underwent MT or without treatment, and no definitive association between the presence of SVS and recanalization rate for acute ischemic stroke.

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Section: Introductionmentioning

confidence: 56%

Section: Discussionmentioning

confidence: 91%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Susceptibility vessel sign as a predictor for recanalization and clinical outcome in acute ischaemic stroke: A Systematic Review and Meta-analysis

Tang

Sen

2021

Preprint

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“…Arterial thrombi are rich in platelets, while cardiac thrombi are rich in erythrocytes and fibrin (1). When oxyhemoglobin in erythrocytes is converted to deoxyhemoglobin, methemoglobin, and hemosiderin, the increased paramagnetic susceptibility enhances the blooming hypointense signal known as the susceptibility vessel sign (SVS), on T2*-weighted and susceptibility-weighted imaging (SWI) in magnetic resonance imaging (MRI) (2)(3)(4)(5). Many studies have demonstrated that the SVS is correlated with cardioembolic stroke (2)(3)(4).…”

Section: Introductionmentioning

confidence: 99%

Predictive value of thrombus susceptibility for cardioembolic stroke by quantitative susceptibility mapping

Chen¹,

Zhang²,

Nie³

et al. 2022

Quant Imaging Med Surg

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Background: The hypointense blooming signal of thrombi on susceptibility-weighted imaging (SWI), known as the susceptibility vessel sign (SVS), is predictive of cardioembolic stroke. The SVS originates from the local magnetic susceptibility effect; thus, the susceptibility value of thrombi may provide useful information in discriminating stroke etiology. We aim to utilize quantitative susceptibility mapping (QSM) to assess thrombus's susceptibility value in acute ischemic stroke patients and explore the relationship of thrombus susceptibility with cardioembolic stroke.Methods: From 2018 to 2020, 132 consecutive acute ischemic stroke patients with middle cerebral artery occlusion were recruited within 48 hours of onset. All patients underwent a three-dimensional multi-echo SWI scan using a 3 Tesla magnetic resonance imaging scanner. The SVS presence and the diameter of the SVS-related hypointense signal were assessed on SWI. QSM was applied to compute the susceptibility value of the thrombus. The receiver operating characteristic (ROC) methodology was used to define the optimal cutoff value of the susceptibility in QSM and the diameter on SWI for predicting cardioembolic stroke. Results:The SVS was identified in 93 (70.5%) patients with symptomatic middle cerebral artery occlusion and was significantly associated with cardioembolism. The hyperintense signal on QSM in the corresponding middle cerebral artery occlusion was present in 116 (87.9%) patients. ROC analysis indicated that thrombus susceptibility had a greater area under the curve than that of the SVS diameter (0.88 vs. 0.70, P<0.001) and that the optimal cutoff value of thrombus susceptibility for cardioembolism was 0.35 ppm.Multivariate analysis demonstrated that thrombus susceptibility (≥0.35 ppm) was an independent predictor of cardioembolic stroke (odds ratio =20.75; 95% CI, 7.19-59.87; P<0.001), with sensitivity, specificity, a positive predictive value, and a negative predictive value of 85.2%, 80.8%, 75.4%, and 88.7%, respectively, while the SVS presence showed sensitivity, specificity, a positive predictive value, and a negative predictive value of 90.7%, 43.6%, 87.2%, and 52.7%, respectively. Conclusion:Thrombus susceptibility provides superior diagnostic performance over the SVS for discriminating between cardioembolism and other stroke subtypes. Quantitative susceptibility measurements of thrombi may help predict cardioembolic stroke in patients with acute middle cerebral artery occlusion.

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A novel nomogram predicting early neurological deterioration after intravenous thrombolysis for acute ischemic stroke

Luo,

Yuan,

Kuang

et al. 2024

Heliyon

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The different clinical value of susceptibility vessel sign in acute ischemic stroke patients under different interventional therapy: A systematic review and meta-analysis

Cited by 18 publications

References 46 publications

Susceptibility vessel sign as a predictor for recanalization and clinical outcome in acute ischaemic stroke: A Systematic Review and Meta-analysis

Susceptibility vessel sign as a predictor for recanalization and clinical outcome in acute ischaemic stroke: A Systematic Review and Meta-analysis

Predictive value of thrombus susceptibility for cardioembolic stroke by quantitative susceptibility mapping

A novel nomogram predicting early neurological deterioration after intravenous thrombolysis for acute ischemic stroke

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