Proximal bright vessel sign on arterial spin labeling magnetic resonance imaging in acute cardioembolic cerebral infarction
Proximal bright vessel sign on arterial spin labeling magnetic resonance imaging in acute cardioembolic cerebral infarction
复制标题
急性心源性脑梗死动脉自旋标记磁共振成像近端亮血管征
DOI：
10.1016/j.jstrokecerebrovasdis.2017.03.015
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发表时间：
2017
期刊：
影响因子：
--
通讯作者：
Ogawa T.
中科院分区：
文献类型：
--
作者：
Kato A;Shinohara Y;Kuya K;Sakamoto M;Kowa H;Ogawa T.
大血管闭塞处自旋标记血充血在三维伪连续动脉自旋标记灌注磁共振成像（近端明亮血管征象）上可表现为高信号。本研究的目的是阐明急性心源性脑梗死近端亮血管征象与易感血管征象的区别。方法对42例前循环区心源性脑梗死患者进行磁共振成像，包括弥散加权成像、3维伪连续动脉自旋标记灌注成像、T2*加权成像和3维飞行时间磁共振血管成像。近端明亮血管征象和易感血管征象的视觉评估由2名经验丰富的神经放射学家进行。这些征象与磁共振血管造影闭塞部位的关系也进行了探讨。结果42例心源性脑梗死患者中，近端血管亮征24例（57.1%），易感征25例（59.5%）。近端明亮血管征象与易感血管征象清晰19例，近端明亮血管征象与易感血管征象不清楚12例，不匹配11例。6例近端明亮血管征象不清、易感血管征象清晰的患者中，4例显示大脑中动脉远端闭塞，5例近端明亮血管征象清晰、易感血管征象不清的患者中，2例磁共振血管造影未显示闭塞。结论心栓性脑梗死患者近端亮血管征象与易感血管征象基本一致。
BackgroundThe congestion of spin-labeled blood at large-vessel occlusion can present as hyperintense signals on perfusion magnetic resonance imaging with 3-dimensional pseudo-continuous arterial spin labeling (proximal bright vessel sign). The purpose of this study was to clarify the difference between proximal bright vessel sign and susceptibility vessel sign in acute cardioembolic cerebral infarction.MethodsForty-two patients with cardioembolic cerebral infarction in the anterior circulation territory underwent magnetic resonance imaging including diffusion-weighted imaging, 3-dimensional pseudo-continuous arterial spin labeling perfusion magnetic resonance imaging, T2*-weighted imaging, and 3-dimensional time-of-flight magnetic resonance angiography using a 3-T magnetic resonance scanner. Visual assessments of proximal bright vessel sign and the susceptibility vessel sign were performed by consensus of 2 experienced neuroradiologists. The relationship between these signs and the occlusion site of magnetic resonance angiography was also investigated.ResultsAmong 42 patients with cardioembolic cerebral infarction, 24 patients showed proximal bright vessel sign (57.1%) and 25 showed susceptibility vessel sign (59.5%). There were 19 cases of proximal bright vessel sign and susceptibility vessel sign-clear, 12 cases of proximal bright vessel sign and susceptibility vessel sign-unclear, and 11 mismatched cases. Four out of 6 patients with proximal bright vessel sign-unclear and susceptibility vessel sign-clear showed distal middle cerebral artery occlusion, and 2 out of 5 patients with proximal bright vessel sign-clear and susceptibility vessel sign-unclear showed no occlusion on magnetic resonance angiography.ConclusionsProximal bright vessel sign is almost compatible with susceptibility vessel sign in patients with cardioembolic cerebral infarction.