Fluid-attenuated inversion recovery vascular hyperintensity: Correlation with other radiologic findings in acute ischemic stroke with middle cerebral artery occlusion
- Author:
Chan-Chan Li
;
Le-Kang Yin
;
Xiao-Xue Zhang
;
Xiao-Zhu Hao
;
Jia-Qi Tian
;
Zhen-Wei Yao
;
Xiao-Yuan Feng
;
Yan-Mei Yang
- Publication Type:Original article
- Keywords:
Acute ischemic stroke;
middle cerebral artery occlusion;
CT perfusion;
magnetic resonance imaging;
fluid-attenuated inversion recovery
- MeSH:
Infarction, Middle Cerebral Artery
- From:Neurology Asia
2017;22(3):193-202
- CountryMalaysia
- Language:English
-
Abstract:
Objective: To assess fluid-attenuated inversion recovery (FLAIR) vascular hyper-intensity (FVH) and
explore its relationship with CT perfusion (CTP) penumbral/infarct core mismatch ratio and diffusion
weighted imaging (DWI) final infarct volume in acute ischemic stroke (AIS) patients with middle
cerebral artery occlusion (MCAO). Methods: The CTP and MRI images of 38 AIS patients with MCAO
were reviewed. The FVH score (longitudinal direction) [FVH score (L)] and FVH score (transverse
direction) [FVH score (T)] were quantified on the FLAIR images. The FVH score (L) (range, 0-16)
was based on a rostrocaudal extension of FVH and the FVH score (T) (range, 0-3) was based on FVH
supply of the occluded MCA territory. The mismatch ratio was calculated from the ratio of the [mean
transit time - cerebral blood volume (CBV)] lesion/CBV lesion on the CTP images. The DWI infarct
volume was measured on the DWI images. Results: The mismatch ratio was larger for the group of
FVH score (L)=7~8 than those of FVH score (L)=5~6 and FVH score (L)=3~4 (p=0.03), whereas
the DWI infarct volume was smaller (p=0.04). Similarly, the mismatch ratio of FVH score (T)=2~3
group was larger than FVH score (T)=1 group (p=0.01), whereas the DWI infarct volume was smaller
(p=0.02). Both FVH score (L) and FVH score (T) correlated positively with mismatch ratio (P=0.02,
P=0.001, respectively), but negatively with DWI infarct volume (P=0.03, P=0.004, respectively).
Conclusions: Higher FVH score is associated with larger mismatch ratio and smaller DWI infarct
volume in AIS patients with MCAO. FLAIR vascular hyperintensity may represent collateral arterial
circulation, and may play a role in protecting the ischemic penumbra.
