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J Neuroimaging. 2016 May;26(3):355-9. doi: 10.1111/jon.12312. Epub 2015 Nov 10.

Sequential MR Assessment of the Susceptibility Vessel Sign and Arterial Occlusion in Acute Stroke.

Author information

1
Cerebrovascular Unit, Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, 69677, Bron Cedex, France.
2
Université de Lyon CREATIS, CNRS UMR5220, INSERM U1044, INSA-Lyon, Université Lyon 1, Hospices Civils de Lyon, France.
3
Neuroradiology Department, Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, 69677, Bron Cedex, France.
4
Service de Biostatistiques, Hospices Civils de Lyon, Lyon 69003, France; CNRS UMR 5558, Equipe Biostatistique Santé, Pierre-Bénite, F-69310, France; Université Lyon I, Villeurbanne, F-69100, France.
5
Department of Clinical Medicine, Center of Functionally Integrative Neuroscience, Aarhus University, Aarhus, Denmark.
6
Departments of Diagnostic and Interventional Neuroradiology, University Hospital Hamburg-Eppendorf, Hamburg, Germany.
7
Department of Radiology (IDI), Girona Biomedical Research Institute (IDIBGI), Hospital Universitari de Girona Dr Josep Trueta, Girona, Spain.
8
INSERM U894, Université Paris Descartes, Sorbonne Paris Cité, France.

Abstract

PURPOSE:

Susceptibility vessel sign (SVS) may likely influence recanalization after thrombolysis. We assessed, through the European sequential MRI database "I-KNOW," the relationship between the presence of SVS on T2-weighted gradient echo imaging, its angiographic counterpart on magnetic resonance angiography and its subsequent impact on recanalization after thrombolysis.

MATERIALS AND METHODS:

Initial clinical and MRI characteristics and early follow up were analyzed in acute ischemic stroke patients treated with rt-Pa within 4.5 hours. Patients underwent multimodal MRI at admission. Sequential imaging performed 3 hours, 2 days and 1 month later allowed the analysis of SVS changes and recanalization.

RESULTS:

Fifty patients were included in the study. SVS was observed in 54% of cases at admission. SVS was still present in 46% patients at 3 hours, 16% at 2 days, and 0% at 1 month. It was an independent predictor of no recanalization after thrombolysis (P = .04). After 3 hours, SVS disappeared in only 4 cases, and was not linked with recanalization on MRA. Conversely, when SVS persisted, a partial or complete recanalization was observed in 9 and 6 cases, respectively.

CONCLUSIONS:

SVS is a predictor of lower recanalization rate. Its disappearance is not necessarily correlated with recanalization.

KEYWORDS:

MRI; acute ischemic stroke; gradient echo imaging

PMID:
26552863
DOI:
10.1111/jon.12312
[Indexed for MEDLINE]

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