Significance of hyperintense arteries on Gd-enhanced 3D T1W black-blood imaging in acute stroke
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To elucidate the pathogenesis of hyperintense arteries on Gd-enhanced 3D T1W BB FSE and their clinical significance in acute middle cerebral artery (MCA) stroke.
We retrospectively reviewed 20 patients with MCA infarction. We measured the contrast-to-noise ratio between hyperintense artery and adjacent grey matter on T2-FLAIR and Gd-enhanced 3D T1W BB FSE and compared them by using Student’s t test. The agreement of positive hyperintense artery between T2 FLAIR and Gd-enhanced 3D T1WI BB FSE was estimated with intraclass correlation coefficient. Our cohort was dichotomised into two groups depending on hyperintense artery scores, and clinical data were compared between two groups by using Student’s t test and chi-square test.
The contrast between hyperintense artery and grey matter on Gd-enhanced 3D T1W BB FSE was significantly higher than that on T2-FLAIR (2.27 ± 1.65 versus 0.94 ± 0.86, p = 0.01). Overall, agreement of hyperintense arteries on T2-FLAIR and Gd-enhanced 3D T1W BB FSE was excellent (ρ = 0.76, p < 0.01). Patients with higher hyperintense artery scores had higher perfusion deficits that those with lower hyperintense artery scores (196.7 ± 41.4 vs 100.1 ± 130.1, p = 0.03).
Hyperintense arteries on Gd-enhanced 3D T1W BB FSE in acute MCA stroke may be associated with slow collateral flows. Their territories corresponded to those of FLAIR, but had a better contrast. The patients with hyperintense arteries in a wider territory showed larger perfusion deficit than those with hyperintense arteries in a narrower territory.
• Hyperintense arteries on Gd-enhanced 3D T1W BB FSE are slow collateral flows.
• Hyperintense arteries on Gd-enhanced 3D T1W BB FSE are well matched with FLAIR hyperintense vessels.
• Hyperintense arteries are associated with perfusion deficit in stroke patients.
KeywordsArteries Magnetic resonance imaging Stroke
- 3D T1W BB FSE
Three-dimensional T1-weighted black-blood fast spin echo
Alberta stroke program early CT score
Fluid attenuated inversion recovery
Internal carotid artery
Middle cerebral artery
Modified Rankin scale
National Institutes of Health Stroke Scale
The authors state that this work has not received any funding.
Compliance with ethical standards
The scientific guarantor of this publication is Kyung-Yul Lee.
Conflict of interest
The authors of this manuscript declare no relationships with any companies whose products or services may be related to the subject matter of the article.
Statistics and biometry
No complex statistical methods were necessary for this paper.
Written informed consent was waived by the institutional review board.
Institutional review board approval was obtained.
• diagnostic or prognostic study
• performed at one institution
- 11.Kato Y, Higano S, Tamura H et al (2009) Usefulness of contrast-enhanced T1-weighted sampling perfection with application-optimized contrasts by using different flip angle evolutions in detection of small brain metastasis at 3T MR imaging: comparison with magnetization-prepared rapid acquisition of gradient echo imaging. AJNR Am J Neuroradiol 30:923–929CrossRefPubMedGoogle Scholar
- 30.Jovin TG, Liebeskind DS, Gupta R et al (2011) Imaging-based endovascular therapy for acute ischemic stroke due to proximal intracranial anterior circulation occlusion treated beyond 8 hours from time last seen well: retrospective multicenter analysis of 237 consecutive patients. Stroke 42:2206–2211CrossRefPubMedGoogle Scholar
- 33.Schellinger PD, Bryan RN, Caplan LR et al (2010) Evidence-based guideline: the role of diffusion and perfusion MRI for the diagnosis of acute ischemic stroke: report of the Therapeutics and Technology Assessment Subcommittee of the American Academy of Neurology. Neurology 75:177–185CrossRefPubMedPubMedCentralGoogle Scholar
- 36.Streiner DL, Norman GR (1995) Health measurement scales: a practical guide to their development and use, 2nd edn. Oxford University Press, OxfordGoogle Scholar
- 37.Jang W, Kwak HS, Chung GH, Hwang SB (2018) Three-dimensional black-blood contrast-enhanced MRI improves detection of intraluminal thrombi in patients with acute ischaemic stroke. Eur Radiol. https://doi.org/10.1007/s00330-018-5323-4
- 52.Klijn CJ, Kappelle LJ, Algra A, van Gijn J (2001) Outcome in patients with symptomatic occlusion of the internal carotid artery or intracranial arterial lesions: a meta-analysis of the role of baseline characteristics and type of antithrombotic treatment. Cerebrovasc Dis 12:228–234CrossRefPubMedGoogle Scholar