Abstract
We aim to evaluate the value of fast fluid-attenuated inversion recovery (FLAIR) vascular hyperintensity (FVH) in assessing infarct morphology in patients with symptomatic internal carotid artery (ICA) or middle cerebral artery (MCA) occlusions. Magnetic resonance (MR) diffusion-weighted imaging (DWI) FLAIR sequences, and carotid/cerebral magnetic resonance angiography of 102 patients with symptomatic ICA or MCA occlusions were evaluated. The location and score of FVH were determined using Olindo’s method; patients were classified as having Low or High FVHs based on FVH score, and either Distal or Proximal FVH based on FVH location. The differences between infarct morphologies were analyzed. FVH were detectable in 62 patients with High FVH and in 40 patients with Low FVHs based on the Olindo’s scale. There were no statistically significant differences in age, gender, hypertension, diabetes, hyperlipidemia, smoking history, and vascular occlusive site between High and Low FVHs patients, except for infarct morphology (P<0.01). Patients with Distal FVH presented with significant (P<0.01) perforating artery and border zone infarcts, whereas those with Proximal FVH had significant (P<0.01) large territorial infarcts. The scores and locations of FVH could be a predictive imaging marker for infarct morphology in patients with symptomatic ICA or MCA occlusion.
Highlights
Cerebral collateral circulations can be classified as the extra cranial-intracranial collateral circulation, Willis’s cycle, and leptomeningeal collateral circulation
The primary objective of this study was to explore the relationship between FLAIR vascular hyperintensity (FVH) and infarct morphology in patients with symptomatic internal carotid artery (ICA) or middle cerebral artery (MCA) occlusions
Patients were included if they had: (1) an acute anterior circulation infarction within 1 week of the onset of symptoms, (2) large-artery atherosclerotic thrombosis based on the Trial of ORG 10172 in Acute Stroke Treatment (TOAST), (3) completed cerebral magnetic resonance imaging (MRI) inspections, including the diffusion-weighted imaging (DWI) and fluid-attenuated inversion recovery (FLAIR) sequences, carotid three-dimensional contrast-enhanced magnetic resonance angiography (3D CE-MRA) and cerebral magnetic resonance angiography (MRA), (4) carotid or cerebral MRA indicated ICA or MCA
Summary
Cerebral collateral circulations can be classified as the extra cranial-intracranial collateral circulation, Willis’s cycle, and leptomeningeal collateral circulation. Good collateral circulation can restrain the infarct range of ischemic strokes, and predict the clinical manifestations and prognoses [1] of patients with an infarct. Miteff et al [2] considered good collateral circulation as a useful indicator of excellent prognosis of thrombolytic therapy. Assessment of ICA/MCA infarct using FLAIR FVH
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
