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Yang L, Yu L, Qin W, Li Y, Yang S, Li X, Hu W. The Influence of Cerebral Arterial Circle on Prominent Hypointense Vessel Signs in Patients With Internal Carotid Artery Occlusion. Front Neurol 2022; 12:753877. [PMID: 35095716 PMCID: PMC8794947 DOI: 10.3389/fneur.2021.753877] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Accepted: 12/15/2021] [Indexed: 11/13/2022] Open
Abstract
Background and PurposePrevious studies on the presence of asymmetrical prominent cortical and medullary vessel signs (APCV/APMV) and collateral circulation in patients with internal carotid artery occlusion internal carotid artery occlusion (ICAO) are rare, and the conclusions are inconsistent. Our study aimed to investigate the relationship between the presence of APCV/APMV and collateral circulation in patients with ICAO.MethodsPatients with acute ischemic stroke with ICAO were recruited in this study. All 74 patients were divided into two groups depending on the presence of APCV and APMV. The status of the cerebral arterial circle (CAC) was graded as poor or good. The poor CAC was defined as MCA was invisible. Severe stroke was defined as cerebral watershed infarction (CWI) or territorial infarction (TI). Clinical and radiological markers were compared between these two groups. Logistic regression was used to investigate the association between the APCV/APMV and clinical and radiological markers.ResultsA total of 74 patients with ICAO were enrolled. Forty-three patients (58.1%) presented with an APCV and APMV was found in 35 (47.2%) patients. Compared with patients with non-APCV, patients with APCV had a more severe stroke (P = 0.038) and had a significantly higher incidence of poor CAC (P = 0.022) than those with APCV. Patients with APMV had a more severe stroke (P = 0.001). Logistic regression showed that poor CAC was independently associated with APCV and severe stroke were independently associated with APMV.ConclusionsOur study demonstrates that poor CAC was independently associated with the presence of the APCV in patients with ICAO. Severe stroke was independently associated with the APMV.
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Affiliation(s)
- Lei Yang
- Department of Neurology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
- *Correspondence: Lei Yang
| | - Ling Yu
- Department of Endocrinology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
| | - Wei Qin
- Department of Neurology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
| | - Yue Li
- Department of Neurology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
| | - Shuna Yang
- Department of Neurology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
| | - Xuanting Li
- Department of Neurology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
| | - Wenli Hu
- Department of Neurology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
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Li Z, Bai X, Gao P, Lin Y, Ju Y, Sui B. Changes of prominent vessel sign and susceptibility vessel sign in acute ischemic stroke patients with and without successful recanalization: a study based on susceptibility weighted images. Neurol Res 2022; 44:583-590. [PMID: 35001834 DOI: 10.1080/01616412.2021.2024729] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
OBJECTIVES To investigate the changes of prominent vessel sign (PVS) and susceptibility vessel sign (SVS) in acute ischemic stroke (AIS) patients with successful and non-successful vascular recanalization treatment, and to study the associations between the susceptibility-weighted imaging (SWI) findings and early clinical and imaging prognosis. METHODS Thirty-five patients with the acute MCA territory infarction were retrospectively included and classified into Groupre (n = 25) and Groupnon (n = 10) according to the success of vascular recanalization. NIHSS was used for clinical assessment. PVS and DWI were analyzed using ASPECT scores. Baseline, post-treatment, the changes of PVS and SVS, and SVS length were recorded and compared between two groups. Correlation analysis was performed between SWI factors and early post-treatment clinical and imaging factors. RESULTS The mean PVSpre value was 5.20 ± 1.76 and PVSpost was 8.20 ± 1.86. PVSpre and PVSpost showed statistical significance between Groupre and Groupnon (both p < 0.001). A significant difference wasfound in SVSpost(+) (p < 0.001), SVSpost-pre(+) (p = 0.001), SVSpost-pre length (p = 0.036) and SVSpost length (p = 0.001) between the two groups. A positive correlation was found between PVSpre and DWIpost (p < 0.001, r = 0.564). There were positive correlations between PVS-DWI mismatch and NIHSSpost in Groupre (p = 0.042, r = 0.410) and in Groupnon (p = 0.006, r = 0.789). CONCLUSIONS PVS and SVS changes are influenced by the success of vascular recanalization. However, the changes are unrelated to either early clinical or imaging outcomes in AIS patients. PVS-DWI mismatch can be taken as an imaging biomarker for early clinical outcomes, both for patients with or without successful vascular recanalization.
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Affiliation(s)
- Zhiye Li
- Tiantan Neuroimaging Center of Excellence, China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.,Department of Radiology, Beijing Tiantan Hospital, Capital Medical University, Beijing Neurosurgical Institute, Beijing, China
| | - Xiaoyan Bai
- Department of Radiology, Beijing Tiantan Hospital, Capital Medical University, Beijing Neurosurgical Institute, Beijing, China
| | - Peiyi Gao
- Department of Radiology, Beijing Tiantan Hospital, Capital Medical University, Beijing Neurosurgical Institute, Beijing, China
| | - Yan Lin
- Department of Radiology, Beijing Tiantan Hospital, Capital Medical University, Beijing Neurosurgical Institute, Beijing, China
| | - Yi Ju
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Binbin Sui
- Tiantan Neuroimaging Center of Excellence, China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
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Xu Z, Tong Z, Duan Y, Xing D, Song H, Pei Y, Yang B. Diffusion- and Susceptibility Weighted Imaging Mismatch Correlates With Collateral Circulation and Prognosis After Middle Cerebral Artery M1-Segment Occlusion. Front Neurol 2021; 12:660529. [PMID: 34381410 PMCID: PMC8351464 DOI: 10.3389/fneur.2021.660529] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Accepted: 06/28/2021] [Indexed: 11/24/2022] Open
Abstract
Objective: To explore the relation between diffusion-weighted and susceptibility weighted imaging (DWI-SWI) mismatch and collateral circulation or prognosis in patients with occluded M1 segments of middle cerebral artery (MCA). Methods: We enrolled 59 patients with MCA M1-segment occlusion for a retrospective review of baseline clinical and imaging data. As markers of circulatory collaterals, prominent laterality of posterior (PLPCA) and anterior (PLACA) cerebral arteries on magnetic resonance angiography (MRA) studies and a hyperintense vessel sign (HVS) on T2 fluid-attenuated inversion recovery (FLAIR) images were collectively scored. The extent of acute cerebral infarction was then quantified on DWI, using the Alberta Stroke Program Early CT Score (DWI-ASPECTS). Hypointensity vessel sign prominence (PVS) was also evaluated by SWI and similarly scored (SWI-ASPECT) to calculate DWI-SWI mismatch [(DWI-ASPECTS) – (SWI-ASPECTS)], ranging from −10 to 10 points. Results: DWI-SWI mismatch showed significant associations with PLPCA, PLACA, HVS prominence, and collective collateral scores (all, p < 0.05). National Institutes of Health Stroke Scale (NIHSS), DWI-SWI mismatch, and DWI-ASPECTS also differed significantly according to patient prognosis (good vs. poor) after MCA M1-segment occlusion (p < 0.05). In binary logistic regression analyses, NIHSS and DWI-SWI mismatch emerged as independent prognostic factors (p < 0.05). Conclusions: Collateral circulation may be an important aspect of DWI-SWI mismatch, which in this study correlated with prognostic outcomes of MCA M1-segment occlusion.
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Affiliation(s)
- Zhihua Xu
- Department of Radiology, TongDe Hospital of Zhejiang Province, Hangzhou, China.,Department of Radiology, Center for Neuroimaging, General Hospital of Northern Theater Command, Shenyang, China
| | - Zhenhua Tong
- Department of Scientific Research, General Hospital of Northern Theater Command, Shenyang, China
| | - Yang Duan
- Department of Radiology, Center for Neuroimaging, General Hospital of Northern Theater Command, Shenyang, China.,General Hospital of Northern Theater Command Training Base for Graduate, Jinzhou Medical University, Shenyang, China
| | - Dengxiang Xing
- Center for Medical Data, General Hospital of Northern Theater Command, Shenyang, China
| | - Hongyan Song
- Department of Radiology, General Hospital of Northern Theater Command, Shenyang, China
| | - Yusong Pei
- General Hospital of Northern Theater Command Training Base for Graduate, Jinzhou Medical University, Shenyang, China
| | - Benqiang Yang
- Department of Radiology, General Hospital of Northern Theater Command, Shenyang, China
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Jiang H, Zhang Y, Pang J, Shi C, Liu AF, Li C, Jin M, Man F, Jiang WJ. Susceptibility-diffusion mismatch correlated with leptomeningeal collateralization in large vessel occlusion stroke. J Int Med Res 2021; 49:3000605211013179. [PMID: 34038211 PMCID: PMC8161861 DOI: 10.1177/03000605211013179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Objective To investigate the relationship between asymmetric prominent hypointense vessels (prominent vessel sign, PVS) on susceptibility-weighted imaging (SWI) and leptomeningeal collateralization in patients with acute ischemic stroke due to large vessel occlusion. Methods We retrospectively enrolled patients with M1 segment occlusion of the middle cerebral artery who underwent emergency magnetic resonance imaging and digital subtraction angiography within 24 hours from stroke onset. The extent of PVS on SWI was assessed using the Alberta Stroke Program Early CT Score (ASPECTS). Leptomeningeal collateralization on digital subtraction angiography images was assessed using the American Society of Interventional and Therapeutic Neuroradiology/Society of Interventional Radiology (ASITN/SIR) scale. Spearman’s rank correlation test was performed to explore the correlation of ASITN/SIR scores with SWI-ASPECTS and SWI-diffusion-weighted imaging (DWI) mismatch scores. Results Thirty-five patients were enrolled. There was no significant correlation between SWI-ASPECTS and ASITN/SIR scores. However, SWI-DWI mismatch scores were positively correlated with ASITN/SIR scores. Conclusion The range of PVS on SWI did not closely reflect the collateral status, while the range of SWI-DWI mismatch was significantly correlated with the leptomeningeal collateralization. In patients with acute anterior circulation stroke due to large vessel occlusion, larger SWI-DWI mismatch was associated with better leptomeningeal collaterals.
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Affiliation(s)
- Haifei Jiang
- Medical College of Soochow University, Suzhou, China.,Stroke Center, Tongzhou People's Hospital, Nantong, China
| | - Yiqun Zhang
- New Era Stroke Care and Research Institute, The PLA Rocket Force Characteristic Medical Center, Beijing, China
| | - Jiangxia Pang
- Medical College of Soochow University, Suzhou, China
| | - Chaojie Shi
- Stroke Center, Tongzhou People's Hospital, Nantong, China
| | - Ao-Fei Liu
- New Era Stroke Care and Research Institute, The PLA Rocket Force Characteristic Medical Center, Beijing, China
| | - Chen Li
- New Era Stroke Care and Research Institute, The PLA Rocket Force Characteristic Medical Center, Beijing, China
| | - Min Jin
- New Era Stroke Care and Research Institute, The PLA Rocket Force Characteristic Medical Center, Beijing, China
| | - Fengyuan Man
- New Era Stroke Care and Research Institute, The PLA Rocket Force Characteristic Medical Center, Beijing, China
| | - Wei-Jian Jiang
- Medical College of Soochow University, Suzhou, China.,New Era Stroke Care and Research Institute, The PLA Rocket Force Characteristic Medical Center, Beijing, China
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Jiang HF, Zhang YQ, Pang JX, Shao PN, Qiu HC, Liu AF, Li C, Jin M, Man FY, Jiang WJ. Factors associated with prominent vessel sign on susceptibility-weighted imaging in acute ischemic stroke. Sci Rep 2021; 11:5641. [PMID: 33707446 PMCID: PMC7952411 DOI: 10.1038/s41598-021-84269-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2020] [Accepted: 02/09/2021] [Indexed: 02/06/2023] Open
Abstract
The prominent vessel sign (PVS) on susceptibility-weighted imaging (SWI) is not displayed in all cases of acute ischemia. We aimed to investigate the factors associated with the presence of PVS in stroke patients. Consecutive ischemic stroke patients admitted within 24 h from symptom onset underwent emergency multimodal MRI at admission. Associated factors for the presence of PVS were analyzed using univariate analyses and multivariable logistic regression analyses. A total of 218 patients were enrolled. The occurrence rate of PVS was 55.5%. Univariate analyses showed significant differences between PVS-positive group and PVS-negative group in age, history of coronary heart disease, baseline NIHSS scores, total cholesterol, hemoglobin, anterior circulation infarct, large vessel occlusion, and cardioembolism. Multivariable logistic regression analyses revealed that the independent factors associated with PVS were anterior circulation infarct (odds ratio [OR] 13.7; 95% confidence interval [CI] 3.5–53.3), large vessel occlusion (OR 123.3; 95% CI 33.7–451.5), and cardioembolism (OR 5.6; 95% CI 2.1–15.3). Anterior circulation infarct, large vessel occlusion, and cardioembolism are independently associated with the presence of PVS on SWI.
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Affiliation(s)
- Hai-Fei Jiang
- Medical College of Soochow University, Suzhou, 215123, China.,Department of Neurology, Tongzhou People's Hospital, Nantong, 226300, China
| | - Yi-Qun Zhang
- New Era Stroke Care and Research Institute, The PLA Rocket Force Characteristic Medical Center, Beijing, 100088, China
| | - Jiang-Xia Pang
- Medical College of Soochow University, Suzhou, 215123, China
| | - Pei-Ning Shao
- Department of Neurology, Tongzhou People's Hospital, Nantong, 226300, China
| | - Han-Cheng Qiu
- New Era Stroke Care and Research Institute, The PLA Rocket Force Characteristic Medical Center, Beijing, 100088, China
| | - Ao-Fei Liu
- New Era Stroke Care and Research Institute, The PLA Rocket Force Characteristic Medical Center, Beijing, 100088, China
| | - Chen Li
- New Era Stroke Care and Research Institute, The PLA Rocket Force Characteristic Medical Center, Beijing, 100088, China
| | - Min Jin
- New Era Stroke Care and Research Institute, The PLA Rocket Force Characteristic Medical Center, Beijing, 100088, China
| | - Feng-Yuan Man
- New Era Stroke Care and Research Institute, The PLA Rocket Force Characteristic Medical Center, Beijing, 100088, China
| | - Wei-Jian Jiang
- Medical College of Soochow University, Suzhou, 215123, China. .,New Era Stroke Care and Research Institute, The PLA Rocket Force Characteristic Medical Center, Beijing, 100088, China.
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