Fewer peripheral asymmetrical cortical veins is a predictor of favorable outcome in MCA infarctions with SWI‐DWI mismatch

Tao, Yuan; Ren, Guoli; Guanmin, Quan; Duo, Gao

doi:10.1002/jmri.25965

Cited by 12 publications

(8 citation statements)

References 31 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Considering this confounding factor, our research was focused on SIASO patients, and AIS patients with contralateral ICA or MCA stenosis (more than 50% diameter loss) or occlusion were excluded because the APCVS results were from a comparison within an individual [38]. Another study reported [39] that a peripheral APCVS was positively correlated with the degree of MCA stenosis, and fewer peripheral APCVSs may suggest a favorable outcome of unilateral MCA infarction at the 3-month follow-up. However, they did not elaborate on the relationship between the APCVS and AIS patients in the acute phase.…”

Section: Discussionmentioning

confidence: 99%

Asymmetrical cortical vein sign predicts early neurological deterioration in acute ischemic stroke patients with severe intracranial arterial stenosis or occlusion

Xiao

Luo

et al. 2020

BMC Neurol

View full text Add to dashboard Cite

Background Susceptibility weighted imaging (SWI) provides an approximate assessment of tissue perfusion and shows prominent hypointense cortical veins in the ischemic territory because of the increased concentration of deoxyhemoglobin. We aimed to evaluate whether asymmetrical prominent cortical vein sign (APCVS) on SWI can predict early neurological deterioration (END) in acute ischemic stroke patients with severe intracranial arterial stenosis or occlusion (SIASO). Methods One hundred and nine acute ischemic stroke patients with SIASO who underwent SWI were retrospectively recruited. END was defined as an increase in the National Institutes of Health Stroke Scale score ≧2 points despite standard treatment in the first 72 h after admission. The APCVS was defined as more and/or large vessels with greater signal loss than those in the opposite hemisphere on SWI. Results Thirty out of the 109 (27.5%) patients developed END. Sixty (55.0%) patients presented with APCVS on SWI. APCVS occurred in 24 (80%) patients with END, whereas it only occurred in 36 (45.6%) patients without END (P = 0.001). Patients with APCVS were more likely to have END (40.0%, vs. 12.2%, P = 0.001) than those without END. Multivariate logistic regression indicated that APCVS (OR = 4.349, 95% C.I. = 1.580–11.970, P = 0.004) was a significant predictor of END in acute ischemic stroke patients with SIASO, adjusted for previous stroke history and acute infarct volume. Conclusions In acute ischemic stroke patients with SIASO, the APCVS might be a useful neuroimaging marker for predicting END, which suggests the importance of evaluation of perfusion status.

show abstract

Section: Discussionmentioning

confidence: 99%

Asymmetrical cortical vein sign predicts early neurological deterioration in acute ischemic stroke patients with severe intracranial arterial stenosis or occlusion

Xiao

Luo

et al. 2020

BMC Neurol

View full text Add to dashboard Cite

show abstract

“…19,20 Fewer peripheral asymmetrical prominent veins (on susceptibility weighted imaging) have also been linked to a favorable outcome in unilateral MCA infarction. 21 Due to the relative simplicity and reasonable time requirements of the susceptibility measurement, and ease of calibration to absolute OEF, QSM is an attractive approach to assess regional oxygenation in cerebral vessels.…”

Section: Introductionmentioning

confidence: 99%

Elevated brain oxygen extraction fraction measured by MRI susceptibility relates to perfusion status in acute ischemic stroke

Fan

Khalil

Fiebach

et al. 2019

J Cereb Blood Flow Metab

View full text Add to dashboard Cite

Recent clinical trials of new revascularization therapies in acute ischemic stroke have highlighted the importance of physiological imaging to identify optimal treatments for patients. Oxygen extraction fraction (OEF) is a hallmark of at-risk tissue in stroke, and can be quantified from the susceptibility effect of deoxyhemoglobin molecules in venous blood on MRI phase scans. We measured OEF within cerebral veins using advanced quantitative susceptibility mapping (QSM) MRI reconstructions in 20 acute stroke patients. Absolute OEF was elevated in the affected (29.3 ± 3.4%) versus the contralateral hemisphere (25.5 ± 3.1%) of patients with large diffusion–perfusion lesion mismatch ( P = 0.032). In these patients, OEF negatively correlated with relative CBF measured by dynamic susceptibility contrast MRI ( P = 0.004), suggesting compensation for reduced flow. Patients with perfusion–diffusion match or no hypo-perfusion showed less OEF difference between hemispheres. Nine patients received longitudinal assessment and showed OEF ratio (affected to contralateral) of 1.2 ± 0.1 at baseline that normalized (decreased) to 1.0 ± 0.1 at follow-up three days later ( P = 0.03). Our feasibility study demonstrates that QSM MRI can non-invasively quantify OEF in stroke patients, relates to perfusion status, and is sensitive to OEF changes over time. Clinical trial registration: Longitudinal MRI examinations of patients with brain ischemia and blood brain barrier permeability; clinicaltrials.org : NCT02077582

show abstract

“…Considering this confounding factor, our research was focused on SIASO patients, and AIS patients with contralateral ICA or MCA stenosis (more than 50% diameter loss) or occlusion were excluded, because the APCVS results from a comparison within an individual. Another study reported [36] that a peripheral APCVS was positively correlated with the degree of MCA stenosis, and fewer peripheral APCVSs may suggest a favorable outcome of unilateral MCA infarction at the 3-month f0llow-up. However, they did not elaborate on the relationship between the APCVS and AIS patients in the acute phase, although in practice, clinicians are highly concerned about END.…”

Section: Discussionmentioning

confidence: 97%

Asymmetrical Cortical Vein Sign Predicts Early Neurological Deterioration in Acute Ischemic Stroke Patients with Severe Intracranial Arterial Stenosis or Occlusion

Xiao

Luo

et al. 2020

Preprint

View full text Add to dashboard Cite

Background: Susceptibility weighted imaging (SWI) provides a rough assessment of tissue perfusion with the prominent hypointense cortical veins in the ischemic territory due to increased concentration of deoxyhemoglobin. We aimed to evaluate whether asymmetrical prominent cortical vein sign (APCVS) on SWI can predict early neurological deterioration (END) in acute ischemic stroke patients with severe intracranial arterial stenosis or occlusion (SIASO).Results: One hundred and nine acute ischemic stroke patients with SIASO who underwent SWI were retrospectively recruited. END was defined as a National Institutes of Health Stroke Scale (NIHSS) increasement≧2 points despite standard treatment in the first 72h after admission. APCVS was defined as more and/or large vessels with greater signal loss than those in the opposite hemisphere on SWI. Thirty out of the 109 (27.5%) patients developed END. Sixty (55.0%) patients presented with APCVS on SWI. APCVS occurred in 24 (80%) patients with END, whereas it only occurred in 36 (45.6%) patients without END (P=0.001). Patient with APCVS were more likely to have END (40.0%, vs. 12.2%, P=0.001), in comparation with those without END. Multivariate logistic regression indicated that APCVS (OR=4.349, 95% C.I.=1.580-11.970, P=0.004) was a significant predictor of END in acute ischemic stroke patients with SIASO, adjusted for previous stroke history and acute infarct volume.Conclusions: In acute ischemic stroke patients with SIASO, APCVS might be a useful neuroimaging marker for predicting END, suggesting the importance of evaluation of perfusion status.

show abstract

Fewer peripheral asymmetrical cortical veins is a predictor of favorable outcome in MCA infarctions with SWI‐DWI mismatch

Abstract: 3 Technical Efficacy: Stage 5 J. Magn. Reson. Imaging 2018;48:964-970.

Cited by 12 publications

References 31 publications

Asymmetrical cortical vein sign predicts early neurological deterioration in acute ischemic stroke patients with severe intracranial arterial stenosis or occlusion

Asymmetrical cortical vein sign predicts early neurological deterioration in acute ischemic stroke patients with severe intracranial arterial stenosis or occlusion

Elevated brain oxygen extraction fraction measured by MRI susceptibility relates to perfusion status in acute ischemic stroke

Asymmetrical Cortical Vein Sign Predicts Early Neurological Deterioration in Acute Ischemic Stroke Patients with Severe Intracranial Arterial Stenosis or Occlusion

Contact Info

Product

Resources

About