Prognostic value of fluid-attenuated inversion recovery hyperintense vessel sign in endovascular recanalization of acute middle cerebral artery occlusion / 中华放射学杂志

ABSTRACT

Objective To explore the prognostic effect of hyperintense vessel sign (hyperintense vessel sign,HVS) in fluid-attenuated inversion recovery (FLAIR) on endovascular recanalization of acute ischemic stroke.Methods The clinical and imaging data of the patients with acute middle cerebral artery (MCA) occlusion treated by endovascular therapy from January 2013 to october 2015 were analyzed retrospectively.The inclusion criteria(1)＜8 h after symptom onset;(2) The preoperative MRI included conventional non-enhanced MR,FLAIR,diffusion-weighted imaging (DWI),magnetic resonance angiography (MRA) and DWI-ASPECTS (Alberta Stroke Program Early CT Score) ≥7;(3) acute MCA occlusion verified by conventional angiography and recanalizations (TICI score of 2b and 3) were obtained after endovascular therapy;(4) postoperative similar MR examinations were performed within one week.The patients were divided into group A (HVS score＜5) and B (HVS score≥5).The clinical outcomes and radiological characteristics were compared between two groups.Results There were 15 patients in group A and 33 patients in group B.No significant differences were noted in onset-to-MRI interval (4.8±0.7 h vs 4.6± 0.6 h),MRI-to-recanalization interval (2.1 ±0.5 h vs 2.2±0.5 h) and preoperative DWI-ASPECTS score (7.8± 0.9 score vs 8.2± 1.0 score) between the two groups (all P＞0.05).Significant differences were noted in NIHSS score at admission (14.6±2.6 score vs 10.1±2.2 score),grade of collateral circulation (1.6±0.3 score vs 2.4± 0.4 score),postoperative DWI-ASPECTS score (5.6±0.8 score vs 7.3±0.9 score),postoperative extension of DWI-ASPECTS score (2.2±0.4 score vs 0.9±0.2 score),the incidence of cerebral hemorrhage transformation (26.7％ vs 12.1％) and mRS score at 3 months (3.2±0.5 score vs 2.3±0.4) score between the two groups (all P＜0.05).Conclusion HVS score is clearly associated with collateral circulation and high HVS score indicates better functional outcomes than low HVS score.