European Radiology

, Volume 29, Issue 3, pp 1329–1337 | Cite as

Significance of hyperintense arteries on Gd-enhanced 3D T1W black-blood imaging in acute stroke

  • Kyung-Yul Lee
  • Sang Hyun Suh
  • Sung Jun AhnEmail author



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.

Key Points

• 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.


Arteries Magnetic resonance imaging Stroke 



Three-dimensional T1-weighted black-blood fast spin echo


Alberta stroke program early CT score


Cerebrospinal fluid


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.

Informed consent

Written informed consent was waived by the institutional review board.

Ethical approval

Institutional review board approval was obtained.


• retrospective

• diagnostic or prognostic study

• performed at one institution


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Copyright information

© European Society of Radiology 2018

Authors and Affiliations

  1. 1.Department of NeurologyGangnam Severance Hospital, Yonsei University College of MedicineSeoulKorea
  2. 2.Severance Institute for Vascular and Metabolic ResearchYonsei UniversitySeoulKorea
  3. 3.Department of RadiologyGangnam Severance Hospital, Yonsei University College of MedicineSeoulKorea

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