Liang Jiang1, Yu-Chen Chen1, Hong Zhang2, Mingyang Peng1, Huiyou Chen1, Wen Geng1, Quan Xu1, Xindao Yin3, Yuehu Ma4. 1. Department of Radiology, Nanjing First Hospital, Nanjing Medical University, No.68, Changle Road, Nanjing, 210006, China. 2. Department of Radiology, The Affiliated Jiangning Hospital of Nanjing Medical University, Nanjing, China. 3. Department of Radiology, Nanjing First Hospital, Nanjing Medical University, No.68, Changle Road, Nanjing, 210006, China. y.163yy@163.com. 4. Department of Radiology, Nanjing First Hospital, Nanjing Medical University, No.68, Changle Road, Nanjing, 210006, China. mayuehu1976@163.com.
Abstract
PURPOSE: Fluid-attenuated inversion recovery vascular hyperintensity (FVH) is frequently found in stroke patients after intracranial arterial occlusion, but the prognostic value of FVH findings is unclear. We assessed whether FVH is associated with cerebral collateral status and functional outcome in patients with acute stroke patients receiving endovascular therapy. METHODS: FVH score, American Society of Interventional and Therapeutic Neuroradiology (ASITN) grade, the functional outcome at 3 months (modified Rankin Scale (mRS)), and other clinical data were collected for 37 acute stroke patients with large vessel occlusion (LVO) receiving MRI before and after endovascular therapy. Statistical analysis was performed to predict functional outcome after stroke. RESULTS: The good functional outcome group (n = 16) had a higher FVH1 (FVH before therapy) score (4.63 ± 1.20 vs 3.14 ± 1.15; p = 0.001) and ASITN grade (3.31 ± 0.48 vs 2.00 ± 1.22; p < 0.001) and a lower FVH2 (FVH after therapy) score than the poor functional outcome group (n = 21; 0.125 ± 0.50 vs 1.44 ± 2.16; p = 0.030). mRS at 3 months was negatively correlated with FVH1 (r = - 0.525, p = 0.001) and the ASITN grade (r = - 0.478, p = 0.003) and positively correlated with FVH2 (r = 0.376, p = 0.034). FVH1 (OR, 0.085; 95% CI, 0.013-0.577; p = 0.012) and FVH2 (OR, 2.724; 95% CI, 1.061-6.996; p = 0.037) were independently associated with functional outcome in multivariable logistic regression analysis. CONCLUSIONS: Assessing FVH before and after therapy in acute stroke patients with LVO might be useful for predicting functional outcome after stroke. KEY POINTS: • Fluid-attenuated inversion recovery vascular hyperintensity is a circular or serpentine brightening in the brain parenchyma or cortical surface bordering the subarachnoid space on MR imaging. • A prospective study showed that fluid-attenuated inversion recovery vascular hyperintensity is associated with cerebral collateral circulation and prognosis. • Fluid-attenuated inversion recovery vascular hyperintensity helps clinicians to predict the prognosis of patients with acute stroke.
PURPOSE: Fluid-attenuated inversion recovery vascular hyperintensity (FVH) is frequently found in strokepatients after intracranial arterial occlusion, but the prognostic value of FVH findings is unclear. We assessed whether FVH is associated with cerebral collateral status and functional outcome in patients with acute strokepatients receiving endovascular therapy. METHODS: FVH score, American Society of Interventional and Therapeutic Neuroradiology (ASITN) grade, the functional outcome at 3 months (modified Rankin Scale (mRS)), and other clinical data were collected for 37 acute strokepatients with large vessel occlusion (LVO) receiving MRI before and after endovascular therapy. Statistical analysis was performed to predict functional outcome after stroke. RESULTS: The good functional outcome group (n = 16) had a higher FVH1 (FVH before therapy) score (4.63 ± 1.20 vs 3.14 ± 1.15; p = 0.001) and ASITN grade (3.31 ± 0.48 vs 2.00 ± 1.22; p < 0.001) and a lower FVH2 (FVH after therapy) score than the poor functional outcome group (n = 21; 0.125 ± 0.50 vs 1.44 ± 2.16; p = 0.030). mRS at 3 months was negatively correlated with FVH1 (r = - 0.525, p = 0.001) and the ASITN grade (r = - 0.478, p = 0.003) and positively correlated with FVH2 (r = 0.376, p = 0.034). FVH1 (OR, 0.085; 95% CI, 0.013-0.577; p = 0.012) and FVH2 (OR, 2.724; 95% CI, 1.061-6.996; p = 0.037) were independently associated with functional outcome in multivariable logistic regression analysis. CONCLUSIONS: Assessing FVH before and after therapy in acute strokepatients with LVO might be useful for predicting functional outcome after stroke. KEY POINTS: • Fluid-attenuated inversion recovery vascular hyperintensity is a circular or serpentine brightening in the brain parenchyma or cortical surface bordering the subarachnoid space on MR imaging. • A prospective study showed that fluid-attenuated inversion recovery vascular hyperintensity is associated with cerebral collateral circulation and prognosis. • Fluid-attenuated inversion recovery vascular hyperintensity helps clinicians to predict the prognosis of patients with acute stroke.
Entities:
Keywords:
Angiography; Collateral circulation; Magnetic resonance imaging; Prognosis; Stroke
Authors: Martin Ebinger; Anna Kufner; Ivana Galinovic; Peter Brunecker; Uwe Malzahn; Christian H Nolte; Matthias Endres; Jochen B Fiebach Journal: Stroke Date: 2011-10-27 Impact factor: 7.914
Authors: Peter D Schellinger; Julio A Chalela; Dong-Wha Kang; Lawrence L Latour; Steven Warach Journal: AJNR Am J Neuroradiol Date: 2005-03 Impact factor: 3.825
Authors: Randall T Higashida; Anthony J Furlan; Heidi Roberts; Thomas Tomsick; Buddy Connors; John Barr; William Dillon; Steven Warach; Joseph Broderick; Barbara Tilley; David Sacks Journal: Stroke Date: 2003-07-17 Impact factor: 7.914
Authors: N Sanossian; J L Saver; J R Alger; D Kim; G R Duckwiler; R Jahan; F Vinuela; B Ovbiagele; D S Liebeskind Journal: AJNR Am J Neuroradiol Date: 2008-11-20 Impact factor: 3.825