Hyperintense vessels on acute stroke fluid-attenuated inversion recovery imaging: associations with clinical and other MRI findings.
Hyperintense vessels on acute stroke fluid-attenuated inversion recovery imaging: associations with clinical and other MRI findings.
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DOI：
10.1161/strokeaha.112.658906
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发表时间：
2012-11
期刊：
影响因子：
8.3
通讯作者：
Stroke Imaging Repository (STIR) Investigators
中科院分区：
文献类型：
--
作者：
Cheng B;Ebinger M;Kufner A;Köhrmann M;Wu O;Kang DW;Liebeskind D;Tourdias T;Singer OC;Christensen S;Warach S;Luby M;Fiebach JB;Fiehler J;Gerloff C;Thomalla G;Stroke Imaging Repository (STIR) Investigators
在急性缺血性中风患者的流体衰减反转恢复（FLAIR）成像中观察到高信号血管（HV），并且与侧支动脉循环缓慢血流有关。鉴于 HV 的潜在重要性，我们使用了卒中患者的大型多中心数据集来阐明哪些临床和影像因素在 HV 中发挥作用。我们分析了先前发表的 PRE-FLAIR 研究中 516 名患者的数据。症状出现后 12 小时内对患者进行 MRI 研究。 HV 被定义为 FLAIR 中的高信号，对应于血管的典型走行，不被认为是扩散限制同侧的近端闭塞主动脉。 HV 的存在由两名观察者进行评估，并与临床和影像学结果相关。在所有 516 名患者中，有 240 名患者 (47%) 被发现存在 HV。 HV 患者表现出较大的初始缺血性病变体积（中位 12.3 vs. 4.9 ml；p<0.001）和更严重的临床损伤（中位 NIHSS 10.5 vs. 6；p<0.001）。在 198 名接受 MR 血管造影的患者中，80% 的血管闭塞患者发现 HV，17% 的无血管闭塞患者发现 HV。在多变量逻辑回归模型中，血管闭塞与 HV 相关（OR 21.7%；95% CI 9.6–49.9，p < 0.001）。 HV 检测血管闭塞的特异性为 0.86 (95% CI 0.80–0.90)，敏感性为 0.76 (95% CI 0.69–0.83)。 HV 是与近端动脉闭塞和更严重的中风相关的常见发现。 HV 预测动脉闭塞，诊断准确度高。
Hyperintense vessels (HV) have been observed in Fluid-Attenuated Inversion Recovery (FLAIR) imaging of patients with acute ischemic stroke and been linked to slow flow in collateral arterial circulation. Given the potential importance of HV, we used a large, multicentre dataset of stroke patients to clarify which clinical and imaging factors play a role in HV. We analyzed data of 516 patients from the previously published PRE-FLAIR study. Patients were studied by MRI within 12 hours of symptom onset. HV were defined as hyperintensities in FLAIR corresponding to the typical course of a blood vessel that was not considered the proximal, occluded main artery ipsilateral to the diffusion restriction. Presence of HV was rated by two observers and related to clinical and imaging findings. Presence of HV was identified in 240 of all 516 patients (47%). Patients with HV showed larger initial ischemic lesion volumes (median 12.3 vs. 4.9 ml; p<0.001) and a more severe clinical impairment (median NIHSS 10.5 vs. 6; p<0.001). In 198 patients with MR-angiography, HV were found in 80% of patients with vessel occlusion and in 17% without vessel occlusion. In a multivariable logistic regression model, vessel occlusion was associated with HV (OR 21.7%; 95% CI 9.6–49.9, p < 0.001). HV detected vessel occlusion with a specificity of 0.86 (95% CI 0.80–0.90) and sensitivity of 0.76 (95% CI 0.69–0.83). HV are a common finding associated with proximal arterial occlusions and more severe strokes. HV predict arterial occlusion with high diagnostic accuracy.