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AJNR Am J Neuroradiol. 2015 Dec;36(12):2346-53. doi: 10.3174/ajnr.A4483. Epub 2015 Aug 27.

Susceptibility Vessel Sign on MRI Predicts Favorable Clinical Outcome in Patients with Anterior Circulation Acute Stroke Treated with Mechanical Thrombectomy.

Author information

1
From the Departments of Diagnostic and Interventional Neuroradiology (R.B., S.V., B.D.-D., A.L.-G., H.D.) romain.bourcier2@gmail.com.
2
From the Departments of Diagnostic and Interventional Neuroradiology (R.B., S.V., B.D.-D., A.L.-G., H.D.).
3
Centre d'investigation clinique Thorax (B.G.), l'institut du thorax, Centre Hospitalier Universitaire Nantes, Nantes, France Institut National de la Santé et de la Recherche Médicale, UMR1087 (B.G., J.M.S., H.D.), l'institut du thorax, Nantes, France Centre national de la recherche scientifique (B.G,), UMR 6291, Nantes, France.
4
Department of Diagnostic and Interventional Neuroradiology (C.P.), Centre Hospitalier Régional Universitaire de Tours, Bretonneau Hospital, Tours, France.
5
Diagnostic Cardiac and Vascular Imaging (J.M.S.), Centre Hospitalier Universitaire Nantes Hôpital G et R Laënnec, Nantes, France Institut National de la Santé et de la Recherche Médicale, UMR1087 (B.G., J.M.S., H.D.), l'institut du thorax, Nantes, France.
6
From the Departments of Diagnostic and Interventional Neuroradiology (R.B., S.V., B.D.-D., A.L.-G., H.D.) Institut National de la Santé et de la Recherche Médicale, UMR1087 (B.G., J.M.S., H.D.), l'institut du thorax, Nantes, France.

Abstract

BACKGROUND AND PURPOSE:

The susceptibility vessel sign on MR imaging has been reported to indicate acute occlusion from erythrocyte-rich thrombus. The purpose of this study was to evaluate the influence of the susceptibility vessel sign seen on MR imaging before treatment on the clinical outcome after mechanical thrombectomy for anterior circulation acute stroke.

MATERIALS AND METHODS:

We retrospectively included 73 consecutive patients who were treated for anterior circulation acute stroke by mechanical thrombectomy from December 2009 to September 2013. Each patient underwent MR imaging before mechanical thrombectomy. The presence (susceptibility vessel sign+) or absence of the susceptibility vessel sign (susceptibility vessel sign-) was recorded. Mechanical thrombectomy was performed either alone or in association with IV tPA according to the site and time after occlusion. Good functional outcome was defined by an mRS ≤ 2 at 3 months in susceptibility vessel sign+ and susceptibility vessel sign- groups. Patient clinical characteristics, initial NIHSS score and ASPECTS, site of occlusion, time between onset to groin puncture, TICI after mechanical thrombectomy, NIHSS score at day 1, and spontaneous hyperattenuation on CT at day 1 were also analyzed.

RESULTS:

Fifty-three patients with susceptibility vessel sign+ and 20 with susceptibility vessel sign- were included in our study. mRS ≤ 2 at 3 months occurred in 65% patients in the susceptibility vessel sign+ group and 26% in the susceptibility vessel sign- group (P = .004). On multivariate analysis, the susceptibility vessel sign was the only parameter before treatment that could predict mRS ≤ 2 at 3 months (OR, 8.7; 95% CI, 1.1-69.4; P = .04).

CONCLUSIONS:

Our study strongly suggests that the susceptibility vessel sign on MR imaging before treatment is predictive of favorable clinical outcome for patients presenting with anterior circulation acute stroke and treated with mechanical thrombectomy.

PMID:
26316570
DOI:
10.3174/ajnr.A4483
[Indexed for MEDLINE]
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