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Collateral assessment on magnetic resonance imaging/angiography up to 30 hours after stroke onset.

Authors :
Shinya Tomari
Thomas Lillicrap
Carlos Garcia-Esperon
Yumi Tomari Kashida
Andrew Bivard
Longting Lin
Christopher R Levi
Neil J Spratt
Source :
PLoS ONE, Vol 19, Iss 9, p e0309779 (2024)
Publication Year :
2024
Publisher :
Public Library of Science (PLoS), 2024.

Abstract

PurposeWe aimed to validate hyperintense vessel sign (HVS) on FLAIR imaging or posterior cerebral artery (PCA) laterality on MR angiography beyond 4.5 hours after stroke onset.Materials and methodsData from acute ischemic stroke patients with internal carotid or middle cerebral artery occlusion who underwent CT perfusion imaging at baseline, follow-up MR perfusion imaging and angiography within 30 hours after stroke, without effective recanalization on follow-up imaging, were analysed retrospectively. Patients were separately classified as high or low HVS (>5 or ≤5 slices of HVS), and PCA laterality positive or negative group. We compared core and penumbra volumes at follow-up imaging and neurological outcomes between high or low HVS group, and between PCA laterality positive or negative group.ResultsOf 49 patients analyzed, four patients with artifacts were excluded and 45 were classified into high (n = 23) or low (n = 22) HVS group. High group had a smaller core volume (median 32 ml versus 109 ml, p = 0.004), larger penumbra volume at follow-up (68 ml versus 0 ml, p = 0.001), and better outcomes (modified Rankin Scale at three months, 3 versus 5, p = 0.03). For PCA laterality analysis, 1 patient with previously occluded PCA was excluded and 48 patients were classified as positive (n = 22) or negative (n = 26). Positive group had larger core volume (116 ml versus 37 ml), and no significant differences in penumbral volumes or outcomes.ConclusionProminent HVS in later time was associated with small core volume, persistent penumbra volume and favorable outcomes.

Subjects

Subjects :
Medicine
Science

Details

Language :
English
ISSN :
19326203
Volume :
19
Issue :
9
Database :
Directory of Open Access Journals
Journal :
PLoS ONE
Publication Type :
Academic Journal
Accession number :
edsdoj.1a9d0f7229746438a9c4f382edf476f
Document Type :
article
Full Text :
https://doi.org/10.1371/journal.pone.0309779