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

  • Kyung-Yul Lee
  • Sang Hyun Suh
  • Sung Jun Ahn
Neuro
  • 57 Downloads

Abstract

Objectives

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.

Methods

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.

Results

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).

Conclusion

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.

Keywords

Arteries Magnetic resonance imaging Stroke 

Abbreviations

3D T1W BB FSE

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

ASPECTS

Alberta stroke program early CT score

CSF

Cerebrospinal fluid

FLAIR

Fluid attenuated inversion recovery

Gd

Gadolinium

ICA

Internal carotid artery

MCA

Middle cerebral artery

mRS

Modified Rankin scale

NIHSS

National Institutes of Health Stroke Scale

Notes

Funding

The authors state that this work has not received any funding.

Compliance with ethical standards

Guarantor

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.

Methodology

• 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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