Prognostic value of fluid-attenuated inversion recovery imaging vascular hyperintensity in intravenous thrombolysis of acute ischemic stroke
10.3760/cma.j.issn.1006-7876.2014.09.007
- VernacularTitle:磁共振液体衰减反转恢复序列血管高信号对前循环脑梗死静脉溶栓预后的影响
- Author:
Xin CAI
;
Jianzhong SUN
;
Zhicai CHEN
;
Sheng ZHANG
;
Min LOU
- Publication Type:Journal Article
- Keywords:
Brain infarction;
Thrombolytic therapy;
Cerebral arterial diseases;
Constriction,pathologic;
Magnetic resonance imaging;
Reperfusion;
Severity of illness index
- From:
Chinese Journal of Neurology
2014;47(9):628-632
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the prognostic effect of fluid-attenuated inversion recovery imaging vascular hyperintensity (FVH)on intravenous thrombolysis of acute ischemic stroke.Methods We retrospectively reviewed the clinical and imaging data of intravenous thrombolytic patients with acute anterior circulation infarction admitted from May 2009 to December 2013.The presence of FVH was evaluated,and its associations with reperfusion and clinical outcome after thrombolysis were assessed.Results Ninety-three patients were analyzed.FVH was detectable in 55 (59.1％) cases.Patients with FVH had higher NIHSS scores (11.8 ± 6.0 vs 7.2 ± 4.5,P ＜ 0.01),larger initial DWI lesions (5.5 ml vs 2.0 ml,Z =-3.030,P=0.002) and perfusion lesions (42.0 ml vs 3.0 ml,Z=-6.104,P =0.005),compared with those without FVH.The history of hyperlipidemia (OR =0.264,95％ CI 0.07-0.90,P =0.048) and proximal large vessel occlusion(OR =48.874,95％ CI 11.6-205.924,P ＜ 0.01) were independently associated with the presence of FVH.The presence of FVH independently predicted the poor neurological outcome at 3 months (OR =4.143,95 ％ CI 1.440-11.919,P =0.008).However,early reperfusion was associated with favorable outcome in patients with FVH after intravenous thrombolysis (OR =8.500,95％ CI 1.964-36.790,P =0.004).Conclusions The presence of FVH is associated with proximal large vessel occlusion,which predicts poor outcome in patients with intravenous thrombolysis.However,early reperfusion among patients with FVH can improve the outcome.
