Hyperintense vessels on acute stroke fluid-attenuated inversion recovery imaging: associations with clinical and other MRI findings.
Stroke. 2012-08-28; 43(11): 2957-2961
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1. Stroke. 2012 Nov;43(11):2957-61. doi: 10.1161/STROKEAHA.112.658906. Epub 2012 Aug
Hyperintense vessels on acute stroke fluid-attenuated inversion recovery imaging:
associations with clinical and other MRI findings.
Cheng B(1), 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.
Collaborators: Warach S, Albers G, Davis S, Donnan G, Fisher M, Furlan T, Grotta
J, Hacke W, Kang DW, Kidwell C, Lees KR, Lev M, Liebeskind D, Thijs V, Thomalla
G, Wardlaw J, Wintermark M.
(1)Klinik und Poliklinik für Neurologie, Kopf- und Neurozentrum,
Universitätsklinikum Hamburg-Eppendorf, Martinistr 52, 20246 Hamburg, Germany.
BACKGROUND AND PURPOSE: Hyperintense vessels (HVs) have been observed in
fluid-attenuated inversion recovery 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, multicenter data set of patients
with stroke to clarify which clinical and imaging factors play a role in HV.
METHODS: We analyzed data of 516 patients from the previously published PRE-FLAIR
study (PREdictive value of FLAIR and DWI for the identification of acute ischemic
stroke patients≤3 and ≤4.5 hours of symptom onset-a multicenter study) study.
Patients were studied by MRI within 12 hours of symptom onset. HV were defined as
hyperintensities in fluid-attenuated inversion recovery 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
2 observers and related to clinical and imaging findings.
RESULTS: Presence of HV was identified in 240 of all 516 patients (47%). Patients
with HV showed larger initial ischemic lesion volumes (median, 12.3 versus 4.9