Susceptibility Vessel Sign and Cardioembolic Etiology in the THRACE Trial
Clin Neuroradiol. 2018-06-12; 29(4): 685-692
DOI: 10.1007/S00062-018-0699-8
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1. Clin Neuroradiol. 2019 Dec;29(4):685-692. doi: 10.1007/s00062-018-0699-8. Epub
2018 Jun 12.
Susceptibility Vessel Sign and Cardioembolic Etiology in the THRACE Trial.
Bourcier R(1), Derraz I(2), Delasalle B(3)(4), Beaumont M(5)(6)(7), Soize
S(8)(9), Legrand L(10)(11), Desal H(12), Bracard S(2), Naggara O(10)(13)(11),
Oppenheim C(10)(11); THRACE investigators.
Author information:
(1)Department of Diagnostic and Interventional Neuroradiology, Guillaume et René
Laennec University Hospital, Nantes, France. .
(2)Department of Diagnostic and Interventional Neuroradiology, University
Hospital of Montpellier, Montpellier, France.
(3)L’institut du thorax, Centre Hospitalier Universitaire Nantes, Nantes, France.
(4)UMR1087, Institut National de la Santé et de la Recherche Médicale, Nantes,
France.
(5)CIC1433, INSERM, Université de Lorraine, Nancy, France.
(6)IADI, U1254, Université de Lorraine, Nancy, France.
(7)CHRU de Nancy CIC-IT, INSERM, Nancy, France.
(8)Department of Diagnostic and Interventional Neuroradiology, University
Hospital of Reims, Reims, France.
(9)INSERM UMR-S 1237 Physiopathology and imaging of neurological disorders,
Université Caen Normandie, Caen, France.
(10)Department of Neuroradiology, Université Paris-Descartes, Paris, France.
(11)INSERM U894, Sainte-Anne Hospital, Paris, France.
(12)Department of Diagnostic and Interventional Neuroradiology, Guillaume et René
Laennec University Hospital, Nantes, France.
(13)Pediatric Radiology Department, Necker Enfants Malades, Paris, France.
PURPOSE: The susceptibility vessel sign (SVS) has been described on gradient echo
(GRE) magnetic resonance imaging (MRI) in acute ischemic stroke patients by large
vessel occlusion. The presence of SVS (SVS+) was associated with treatment
outcome and stroke etiology with conflicting results. Based on multicenter data
from the THRombectomie des Artères CErebrales (THRACE) study, we aimed to
determine if the association between SVS and cardioembolic etiology (CE) was
independent of GRE sequence parameters.
MATERIAL AND METHODS: Patients with a pretreatment brain GRE sequence were
identified. Logistic regression tested the association between SVS+, CE, time
from onset to imaging and GRE sequence parameters (e.g. echo time, voxel size,
field strength). We calculated the sensitivity, specificity, positive and
negative predictive values (PPV and NPV) for the SVS to predict a stroke from
a CE.
RESULTS: An SVS+ was observed in 237 out of 287 (83%) patients. In the univariate
analysis, there was a significant association between SVS+ and a CE with an odds
ratio (OR) and 95% confidence interval (95% CI) of 2.10 (1.02-4.29), respectively
(p = 0.04) but not with GRE sequence parameters. In multivariate analysis, there
was an independent relationship between SVS+ and CE (OR [95% CI]: 2.14
[1.02-4.45], p = 0.04). Sensitivity and specificity of SVS+ to predict CE were
0.89 and 0.21, respectively. The PPV and NPV of SVS+ were 0.44 and 0.78,
respectively.
CONCLUSION: The presence of SVS is associated to CE, independent of GRE sequence
parameters. While the specificity and the PPV of the sign were low, CE seems less
likely in the absence of an SVS.
DOI: 10.1007/s00062-018-0699-8
PMID: 29947813 [Indexed for MEDLINE]