Significance of change of fluid-attenuated inversion recovery hyperintense vessel sign after endovascular recanalization in acute ischemic stroke / 中华放射学杂志

ABSTRACT

Objective To investigate the significance of change of fluid-attenuated inversion recovery(FLAIR) hyperintense vessel sign(HVS) after endovascular recanalization in acute ischemic stroke. Methods The clinical and imaging data of the patients with acute middle cerebral artery(MCA) occlusion treated by mechanical thrombectomy with Solitaire AB from January 2013 to october 2014 were analyzed retrospectively. The inclusion criteria (1) The preoperative MRI included conventional non-enhanced MR, diffusion-weighted imaging (DWI), magnetic resonance angiography(MRA) and perfusion-weighted imaging (PWI), and HVS was observed on preoperative FLAIR images; (2) acute MCA occlusion verified by conventional angiography;(3) postoperative similar MR images examination was performed within 48 hours. The relationships among postoperative changes in the HVS, DWI and Thrombolysis In Cerebral Ischemia (TICI) scale (1—3) were assessed. Results After endovascular therapy, HVS of the 11 cases were showed to be disappeared(n = 9) and decreased (n = 2). All the 9 patients with disappeared HVS achieved high grade flow (TICI 3), and minor decrease of ischemic area on DWI in 1 case, minor progression in 6, and significant progression in 2. However, of the 2 patients with decreased HVS, one achieved relatively low grade flow (TICI 2a) and the other was found to be relatively high grade flow (TICI 2b), but severe MCA stenosis. DWI demonstrated significant progression in both two cases. Conclusion Our data indicate that endovascular recanalization of acute MCA occlusion was effective for decreasing HVS. Postoperative decrease and disappear in HVS can be considered as a marker for hemodynamic improvement.