Signs of Acute Stroke Seen on Fluid-Attenuated Inversion Recovery MR Imaging

Makkat, Smitha; Vandevenne, Jan; Verswijvel, G; Ijsewijn, Toon; Grieten, Martijn; Palmers, Y; Schepper, A. M. De; Parizel, Paul M.

doi:10.2214/ajr.179.1.1790237

Cited by 21 publications

(18 citation statements)

References 5 publications

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“…e Diffusion-weighted image (TR/TE: 4999 ms/126 ms, b=1000) shows an extensive embolic infarction in the territory of right middle cerebral artery 12 h after the onset of stroke shows tubular arterial hyperintensity in the right sylvian fissure (arrows). Note that arterial hyperintensity is a FLAIR finding associated with artery occlusion or severe stenosis but can occasionally be seen even in patients without recent neurological symptoms FLAIR sequences also provide a unique finding in ischemic lesions [28]. On FLAIR images, arteries with flow rates in the normal range show no signal or lower signal intensity than normal brain tissue.…”

Section: Hyperacute and Acute Infarctionmentioning

confidence: 99%

Abnormal hyperintensity within the subarachnoid space evaluated by fluid-attenuated inversion-recovery MR imaging: a spectrum of central nervous system diseases

Maeda

Yagishita

Yamamoto³

et al. 2003

Eur Radiol

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A variety of central nervous system (CNS) diseases are associated with abnormal hyperintensity within the subarachnoid space (SAS) by fluid-attenuated inversion-recovery (FLAIR) MR imaging. Careful attention to the SAS can provide additional useful information that may not be available with conventional MR sequences. The purpose of this article is to provide a pictorial essay about CNS diseases and FLAIR images with abnormal hyperintensity within the SAS. We present several CNS diseases including subarachnoid hemorrhage, meningitis, leptomeningeal metastases, acute infarction, and severe arterial occlusive diseases such as moya-moya disease. We also review miscellaneous diseases or normal conditions that may exhibit cerebrospinal fluid hyperintensity on FLAIR images. Although the detection of abnormal hyperintensity suggests the underlying CNS diseases and narrows differential diagnoses, FLAIR imaging sometimes presents artifactual hyperintensity within the SAS that can cause the misinterpretation of normal SAS as pathologic conditions; therefore, radiologists should be familiar with such artifactual conditions as well as pathologic conditions shown as hyperintensity by FLAIR images. This knowledge is helpful in establishing the correct diagnosis.

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Section: Hyperacute and Acute Infarctionmentioning

confidence: 99%

Abnormal hyperintensity within the subarachnoid space evaluated by fluid-attenuated inversion-recovery MR imaging: a spectrum of central nervous system diseases

Maeda

Yagishita

Yamamoto³

et al. 2003

Eur Radiol

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“…[1][2][3][4][5][6] Although HV is thought to be similar to the hyperdense artery sign on CT scan or the susceptibility vessel sign on gradient recalled echo (GRE) MRI, it has been shown to be superior to both for the detection of arterial occlusion. 4,7-9 HV usually has longer course than the other two signs and this suggests that different mechanisms other than intraluminal thrombus cause HV.…”

mentioning

confidence: 99%

Distal hyperintense vessels on FLAIR

Lee¹,

Latour²,

Luby³

et al. 2009

Neurology

177

207

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The presence of distal hyperintense vessels before thrombolytic treatment is associated with large diffusion-perfusion mismatch and smaller subacute ischemic lesion volumes in patients with proximal middle cerebral artery occlusion. DWI = diffusion-weighted imaging; FLAIR = fluid-attenuated inversion recovery; GRE = gradient recalled echo; HV = hyperintense vessels; MCA = middle cerebral artery; MRA = magnetic resonance angiography; MTT = mean transit time; NIHSS = NIH Stroke Scale; PWI = perfusion-weighted imaging; rt-PA = recombinant tissue plasminogen activator; TE = echo time; TI = inversion time; TIMI = thrombolysis in myocardial infarction; TR = repetition time.

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“…MRI sequences can be used, as a lack of arterial flow void at the base of the brain on T2-weighted MRI may be indicative of an intracranial occlusion (23). A clot would have altered signal intensity that is different from the normal dark flow void that is a consequence of fast-flowing blood.…”

Section: Imaging Characteristicsmentioning

confidence: 99%

“…An evaluation for the presence of high signal intensity on FLAIR MRI sequences can provide information about cerebral occlusion (2). FLAIR vascular hyperintensity (FVH), a subtle finding (23), is usually seen in the setting of acute ischemic stroke just proximal and distal to the occlusive thrombus. It is not a means of visualizing occlusive thrombus, but rather highlighting its presence by documenting the slowed flow just proximal and distal to the occlusion (46,47).…”

Section: Emerging Imaging Modalitiesmentioning

confidence: 99%

Imaging of Occlusive Thrombi in Acute Ischemic Stroke

Gasparian

Sanossian

Shiroishi

et al. 2014

International Journal of Stroke

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Thrombi, or clots, often occlude proximal segments of the cerebral arterial circulation in acute ischemic stroke. Thromboembolic occlusion or thrombi superimposed on atherosclerotic plaque are the principal focus of acute stroke therapies such as thrombolysis or thrombectomy. We review the imaging characteristics of thrombi on multimodal CT and MRI, angiography and ultrasonography, summarizing recent studies that facilitate therapeutic decision-making from these noninvasive studies. Information about the location, size and imaging characteristics can be ascertained using these techniques. Imaging findings in relation to occlusive thrombus have been correlated with clot pathology, response to therapeutic interventions, and clinical outcome. Diagnostic evaluation of occlusive thrombi on noninvasive studies now constitutes an integral component of acute stroke management.

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Signs of Acute Stroke Seen on Fluid-Attenuated Inversion Recovery MR Imaging

Cited by 21 publications

References 5 publications

Abnormal hyperintensity within the subarachnoid space evaluated by fluid-attenuated inversion-recovery MR imaging: a spectrum of central nervous system diseases

Abnormal hyperintensity within the subarachnoid space evaluated by fluid-attenuated inversion-recovery MR imaging: a spectrum of central nervous system diseases

Distal hyperintense vessels on FLAIR

Imaging of Occlusive Thrombi in Acute Ischemic Stroke

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