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Increased susceptibility of asymmetrically prominent cortical veins correlates with misery perfusion in patients with occlusion of the middle cerebral artery

  • Magnetic Resonance
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Abstract

Objectives

To evaluate tissue perfusion and venous susceptibility in ischaemic stroke patients as a means to predict clinical status and early prognosis.

Methods

A retrospective study of 51 ischaemic stroke patients were enrolled in this study. Susceptibility, perfusion and National Institute of Health stroke scale (NIHSS) were compared between patients with and without asymmetrically prominent cortical veins (APCVs). The correlation between susceptibility, perfusion and NIHSS was performed.

Results

Compared to patients without APCVs, the age of patients with APCVs was statistically older (p = 0.017). Patients with APCVs at discharge showed clinical deterioration in their NIHSS. Mean transit time (MTT), time to peak (TTP) and cerebral blood flow (CBF) in the stroke hemisphere were statistically delayed/decreased in patients with and without APCVs (all p < 0.05). In patients with APCVs, the changes in susceptibility positively correlated with increases in MTT and TTP (p < 0.05). Susceptibility and TTP positively correlated and CBF negatively correlated with NIHSS both at admission and discharge (p < 0.05).

Conclusions

Patients with APCVs have a tendency of deterioration. The presence of APCVs indicates the tissue has increased oxygen extraction fraction. Increased susceptibility from APCVs positively correlated with the delayed MTT and TTP, which reflects the clinical status at admission and predicts an early prognosis.

Key points

• Patients with and without APCVs have similar misery perfusion.

• Patients with APCVs have a tendency of deterioration compared to those without.

• The presence of APCVs indicated the tissue has increased oxygen extraction fraction.

• Increased susceptibility from APCVs positively correlated with the MTT and TTP.

• Increased susceptibility from APCVs reflected the clinical status at admission.

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Abbreviations

APCVs:

Asymmetrical prominent cortical veins

DWI:

Diffusion-weighted imaging

MRA:

Magnetic resonance angiography

NIHSS:

National Institutes of Health Stroke Scale

OEF:

Oxygen extraction fraction

PWI:

Perfusion-weighted imaging

rCBF:

Relative cerebral blood flow

rCBV:

Relative cerebral blood volume

rMTT:

Relative mean transit time

rSus:

Relative susceptibility

rTTP:

Relative time to peak

SWI:

Susceptibility weighted imaging

SWIM:

Susceptibility weighted imaging and mapping

VOI:

Volume of interest

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Acknowledgments

Supported by grants from the Natural Scientific Foundation of China (Grant No. 81501457 to Shuang Xia) and the Tianjin Health Bureau of Science and Technology (Grant No. 14KG103 to Shuang Xia); the National Natural Science Foundation of China (Grant No. 31470047, 81271565 to Meiyun Wang); the Henan Province Scientific and Technological Innovation Talents Project (Grant No. 164200510014 to MeiyunWang); the Shanghai Hongkou District Health Bureau Grand Science and Research Projects Foundation (Grant No.2012-01 to Yu Luo); the Shanghai Health Bureau Science and Research Projects Foundation (Grant No.2012-456 to Yu Luo).

The scientific guarantor of this publication is Shuang Xia and Meiyun Wang. The authors disclose no conflicts of interest. No complex statistical methods were necessary for this paper. Institutional review board approval was obtained. Written informed consent was obtained from all subjects (patients) in this study. No study subjects or cohorts have been previously reported. Methodology: retrospective, observable study. Performed at multiple centres.

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Authors and Affiliations

  1. Radiology Department, Branch of Shanghai First Hospital No.1878, North Sichuan Road, Shanghai, China, 200081

    Yu Luo & Yongming Zhou

  2. Neurological Department, Tianjin First Central Hospital, Tianjin, China, 300192

    Zhongying Gong

  3. Neurosurgery Department, Tianjin First Central Hospital, Tianjin, China, 300192

    Binge Chang

  4. Radiology Department, Tianjin First Central Hospital, Tianjin, China, 300192

    Chao Chai & Shuang Xia

  5. Radiology Department, Zhengzhou University People’s Hospital, Zhengzhou, China, 450003

    Taiyuan Liu, Yanhong Han & Meiyun Wang

  6. Siemens Healthcare, MR collaboration, Northeast Asia, No.7, Wangjing Zhonghuan South Road, Beijing, China, 100102

    Tianyi Qian

  7. Radiology Department, Wayne State University, Detroit, MI, USA

    E Mark Haacke

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  1. Yu Luo
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Correspondence to Meiyun Wang or Shuang Xia.

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Luo, Y., Gong, Z., Zhou, Y. et al. Increased susceptibility of asymmetrically prominent cortical veins correlates with misery perfusion in patients with occlusion of the middle cerebral artery. Eur Radiol 27, 2381–2390 (2017). https://doi.org/10.1007/s00330-016-4593-y

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  • DOI: https://doi.org/10.1007/s00330-016-4593-y

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