Abstract T P44: Grade of Cortical Vessel Signs on Susceptibility-weighted Imaging Predicts Outcomes in Acute Stroke Patients

Abstract

Introduction: Cortical vessel signs (CVSs) on susceptibility-weighted MR imaging (SWI) are frequently observed in acute ischemic stroke patients. However, the clinical implications of this sign have not yet been clearly defined. We assumed the hypothesis that grade of CVSs on SWI predicts outcomes in acute stroke patients. Methods: We retrospectively enrolled stroke patients who presented with anterior circulation cerebral infarction within 24 hours after onset. We excluded patients with no SWI. CVSs was defined as more veins or lager veins with a greater signal loss on SWI than those in the opposite normal hemisphere. CVSs was graded as 1) absent, 2) subtle as presence of CVSs less than 1/3 of the anterior circulation perfusion lesion, or 3) prominent as presence of CVSs more than 1/3 of the perfusion lesion. Unfavorable outcome was defined as discharge modified Rankin scale score 4-6. Results: We included 114 patients from October 2012 to June 2014, 71% of patients were men, median age was 71 years, and the average initial NIHSS score was 7 (range 0-32). CVSs was seen in 53 (47%) of patients. There were 14 patients (13%) with subtle CVSs, and 39 patients (35%) with prominent CVSs. Unfavorable outcome was as follows: 15% of patients with none CVSs, 43% with subtle CVSs, and 59% with prominent CVSs (figure 1). As with grade of CVSs, proportional rate of unfavorable patients gradually increased (P < 0.01). Conclusions: Grade of CVSs on SWI can predict outcomes in acute stroke patients.