FLAIR-hyperintense vessel sign, diffusion-perfusion mismatch and infarct growth in acute ischemic stroke without vascular recanalisation therapy
FLAIR-hyperintense vessel sign, diffusion-perfusion mismatch and infarct growth in acute ischemic stroke without vascular recanalisation therapy
复制标题
DOI：
10.1016/j.neurad.2013.10.004
复制
发表时间：
2014-10-01
影响因子：
3.5
通讯作者：
Hoffmann, Karl Titus
中科院分区：
文献类型：
--
作者：
Gawlitza, Matthias;Gragert, Jasmin;Hoffmann, Karl Titus
背景和目的：探讨DWI-PWI不匹配和FLAIR-高信号血管（FHV）的迹象和它们对预测的梗死增长的中风患者无血管再通therapeutic.Patients和方法之间的关系：33例非腔隙性急性中风，不符合再通治疗接受脑MRI在入院当天和7 +/- 1天后。评估DWI和PWI病变体积、DWI-PWI不匹配体积、梗死生长、相对不匹配和相对梗死生长。FHV征分为近端和远端，远端分为明显和不明显。结果：FHV征不能预测绝对或相对梗死生长。在FHV阳性梗死中观察到明显较大的DWI病变、PWI病变和不匹配体积。FHV征的程度与PWI病灶体积（r = 0.52; P < 0.01）和不匹配体积（r = 0.49; P < 0.01）显著相关，而与DWI初始病灶大小无关（r = 0.33; P = 0.059）。我们发现DWI与PWI的相对不匹配与相对梗死生长之间存在强相关性。（r = 0.91; P < 0.01）但绝对失匹配体积与梗死生长之间无明显相关性（r = 0.18，P = 0.35）。在急性卒中中，FHV征与较大的PWI病变体积和DWI与PWI体积不匹配相关，因此似乎是侧支血流的指标。然而，它是不适合预测梗死生长。后者发生在DWI与PWI不匹配时，存在较大的相对不匹配体积，使随后的梗死生长更有可能。(C)2014年Elsevier Masson SAS。All rights reserved.
Background and purpose: To investigate the relation between DWI-PWI mismatch and FLAIR-hyperintense vessel (FHV) sign and their influence on the prediction of the infarct growth in stroke patients without vessel recanalising therapy.Patients and methods: Thirty-three patients with non-lacunar acute stroke and not eligible for recanalisation therapy received cerebral MRI at the day of admission and after 7 +/- 1 days. DWI and PWI lesion volumes, DWI-PWI mismatch volumes, infarct growth, relative mismatch and relative infarct growth were assessed. FHV sign was subdivided into (i) proximal or (ii) distal, the latter graded as either (i) prominent or (ii) subtle.Results: FHV sign did not predict absolute or relative infarct growth. Significantly larger DWI lesions, PWI lesions and mismatch volumes were observed in FHV-positive infarcts. There were significant correlations between the degree of FHV sign and PWI lesion volume (r = 0.52; P < 0.01) as well as mismatch volume (r = 0.49; P < 0.01), whereas FHV sign did not correlate with the initial DWI lesion size (r = 0.33; P = 0.059). We found a strong correlation between relative DWI-to-PWI mismatch and relative infarct growth (r = 0.91; P < 0.01) yet no correlation between absolute mismatch volumes and infarct growth was evident (r = 0.18, P = 0.35).Conclusion: The FHV sign is associated with larger PWI lesion volumes and DWI-to-PWI mismatch volumes in acute stroke and thus seems to be an indicator of collateral flow. However, it is unsuitable to predict infarct growth. The latter occurred when DWI-to-PWI mismatches were present with bigger relative mismatch volumes making subsequent infarct growth more likely. (C) 2014 Elsevier Masson SAS. All rights reserved.