Susceptibility-Weighted Imaging in Pediatric Arterial Ischemic Stroke: A Valuable Alternative for the Noninvasive Evaluation of Altered Cerebral Hemodynamics

Polan, R.M.; Poretti, Andrea; Huisman, Thierry A.G.M.; Bosemani, Thangamadhan

doi:10.3174/ajnr.a4187

Cited by 30 publications

(25 citation statements)

References 30 publications

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“…S-D mismatch, as another imaging characteristic of PHVS, was considered the penumbra in the reperfusion window period and could be salvageable through the reperfusion therapy or due to the evolution of infarct [12, 23]. The S-D mismatch was also presented beyond the reperfusion window and might predict the stroke progression in pediatric patients [24]. Another study found that S-D mismatch was correlated with good prognosis [14].…”

Section: Discussionmentioning

confidence: 99%

Prominent Hypointense Vessel Sign on Susceptibility-Weighted Imaging Is Associated with Clinical Outcome in Acute Ischaemic Stroke

et al. 2018

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Background: Prominent hypointense vessel sign (PHVS) is visualized on susceptibility weighted-imaging (SWI) in acute ischaemic stroke (AIS). We aim to test if PHVS is associated with stroke outcome. Methods: Forty patients with acute middle cerebral artery occlusion were recruited. The presence of PHVS, cortical vessel sign (CVS), brush sign (BS) and susceptibility-diffuse weighted imaging mismatch (S-D mismatch) and Alberta Stroke Program Early CT Score (ASPECTS) on SWI were compared between the good outcome group (90-day modified Rankin scale [mRS] of 0–2) and the poor outcome group (mRS of 3–6). The receiver operating characteristic curves (ROC) were used to evaluate the predictive ability to poor outcome of above imaging characteristics. Results: The presence of PHVS, CVS, BS and S-D mismatch was significantly higher in the poor outcome group (p < 0.001, p = 0.001, p = 0.013, p = 0.014, respectively). SWI-ASPECTS was significantly lower in the poor outcome group (p = 0.002). Regression analysis revealed SWI-ASPECTS; the presence of PHVS and CVS were independently associated with poor outcome (OR 0.347, p = 0.012; OR 55.77, p = 0.004; OR 58.05, p = 0.005). ROC analysis showed that PHVS had the highest predictive value for poor outcome (AUC 0.783). Conclusions: The presence of PHVS, CVS and SWI-ASPECTS were associated with poor outcome in AIS. The presence of PHVS was the most effective radiographic marker for predicting outcome.

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Section: Discussionmentioning

confidence: 99%

Prominent Hypointense Vessel Sign on Susceptibility-Weighted Imaging Is Associated with Clinical Outcome in Acute Ischaemic Stroke

et al. 2018

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“…[42, 46] These results suggest that SWI-DWI mismatch may be useful in patients who cannot receive contrast for PWI.…”

Section: Clinical Applicationsmentioning

confidence: 97%

“…[41] SWI also allows early detection of hemorrhagic transformation of stroke. [42–44] The presence of intra-arterial thrombus can present on GRE/SWI as intra-arterial low signal and vessel diameter enlargement relative to the contralateral vessel, also termed as “the susceptibility sign”. [41, 43] Infarct/peri-infarct tissue can also demonstrate differences in perfusion parameters secondary to steno-occlusive disease using DSC perfusion.…”

Section: Clinical Applicationsmentioning

confidence: 99%

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Susceptibility-Based Neuroimaging: Standard Methods, Clinical Applications, and Future Directions

et al. 2017

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The evaluation of neuropathologies using MRI methods that leverage tissue susceptibility have become standard practice, especially to detect blood products or mineralization. Additionally, emerging MRI techniques have the ability to provide new information based on tissue susceptibility properties in a robust and quantitative manner. This paper discusses these advanced susceptibility imaging techniques and their clinical applications.

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“…, Thus, noncontrast MR perfusion methods such as arterial spin labelled (ASL) are used more frequently in the pediatric population 48. Susceptibility weighted imaging (SWI) is also a promising tool in childhood AIS, with mismatch of diffusion and hypointense venous SWI signal predicting stroke progression 49. SWI reflects blood oxygenation levels, and SWI values in the veins can provide an alternative assessment of degree of brain perfusion and the perfusion-diffusion mismatch.…”

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confidence: 99%

Role of Imaging in Acute Ischemic Stroke

Pavlina

Radhakrishnan

Vagal

2018

Seminars in Ultrasound, CT and MRI

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Rapid multimodal imaging is essential in the workup and management of acute ischemic stroke. Early parenchymal findings on noncontrast computed tomography or standard magnetic resonance imaging are used to triage patients for intravenous thrombolysis and to provide insight on prognosis. In the wake of recent endovascular stroke trials, advanced techniques including perfusion imaging and noninvasive vascular imaging are becoming important tools to guide potential endovascular treatment or expand therapy windows. Advanced imaging is also important in pediatric ischemic stroke which requires a slightly different workflow and treatment approach. Here, we will discuss key imaging findings in acute ischemic stroke, as well as the present and future of neuroimaging in light of recent and ongoing clinical trials.

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Susceptibility-Weighted Imaging in Pediatric Arterial Ischemic Stroke: A Valuable Alternative for the Noninvasive Evaluation of Altered Cerebral Hemodynamics

Cited by 30 publications

References 30 publications

Prominent Hypointense Vessel Sign on Susceptibility-Weighted Imaging Is Associated with Clinical Outcome in Acute Ischaemic Stroke

Prominent Hypointense Vessel Sign on Susceptibility-Weighted Imaging Is Associated with Clinical Outcome in Acute Ischaemic Stroke

Susceptibility-Based Neuroimaging: Standard Methods, Clinical Applications, and Future Directions

Role of Imaging in Acute Ischemic Stroke

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