Iancu-Gontard Daniela, Oppenheim Catherine, Touzé Emmanuel, Méary Eric, Zuber Mathieu, Mas Jean-Louis, Frédy Daniel, Meder Jean-François
Department of Neuroradiology, Centre Hospitalier Sainte-Anne, Université Paris V, Paris, France.
Stroke. 2003 Aug;34(8):1886-91. doi: 10.1161/01.STR.0000080382.61984.FE. Epub 2003 Jun 26.
Hyperintense vessel sign (HVS) on fluid-attenuated inversion recovery (FLAIR) has been described in hyperacute stroke patients with arterial occlusion. We sought to determine whether HVS was more frequent in patients with intracerebral arterial stenoses than in those without stenosis regardless of the presence of a brain infarct.
In this case-control study (19 symptomatic patients with multiple intracerebral arterial stenoses compared with 19 age-matched asymptomatic patients without stenosis), we looked for HVS (ie, focal or tubular hyperintensities in the subarachnoid space) on FLAIR images. We compared the proportion of HVS-positive patients in the 2 groups and evaluated the concordance between the arterial distribution of stenoses on angiogram and that of HVS on FLAIR.
HVS was found in 13 of 19 patients (68%) in the study group and 1 of 19 control patients (5.2%) (P<0.0001). The concordance between the territorial distribution of stenoses on angiogram and HVS on FLAIR was higher for the right and left middle cerebral artery (kappa=0.6 and 0.63, respectively) compared with the right and left anterior cerebral artery (kappa=0.35 and 0.2, respectively). HVSs were observed in 1 of 7 patients with posterior cerebral artery stenoses on angiogram. HVSs were seen equally in patients with acute focal (7 of 10) or diffuse (6 of 9) cerebral involvement. In the 6 HVS-positive patients with acute stroke confirmed by MRI, additional HVSs were observed in a different arterial territory than that of the stroke lesion.
Although their significance remains unclear, multiple HVSs are more frequently observed in symptomatic patients with multiple intracerebral stenoses than in asymptomatic patients without stenosis.
在动脉闭塞的超急性卒中患者中，已观察到液体衰减反转恢复（FLAIR）序列上的高信号血管征（HVS）。我们试图确定，无论有无脑梗死，脑动脉狭窄患者的HVS是否比无狭窄患者更常见。
在这项病例对照研究中（19例有多处脑动脉狭窄的有症状患者与19例年龄匹配的无狭窄无症状患者进行比较），我们在FLAIR图像上寻找HVS（即蛛网膜下腔内的局灶性或管状高信号）。我们比较了两组中HVS阳性患者的比例，并评估了血管造影上狭窄的动脉分布与FLAIR上HVS的动脉分布之间的一致性。
研究组19例患者中有13例（68%）发现HVS，对照组19例患者中有1例（5.2%）发现HVS（P<0.0001）。与左右大脑前动脉（kappa分别为0.35和0.2）相比，血管造影上狭窄的区域分布与FLAIR上HVS之间的一致性在左右大脑中动脉更高（kappa分别为0.6和0.63）。血管造影显示大脑后动脉狭窄的7例患者中有1例观察到HVS。急性局灶性（10例中的7例）或弥漫性（9例中的6例）脑受累患者中HVS的出现情况相同。在6例经MRI证实为急性卒中的HVS阳性患者中，在与卒中病变不同的动脉区域观察到额外的HVS。
尽管其意义尚不清楚，但有多处脑内狭窄的有症状患者比无狭窄的无症状患者更常观察到多个HVS。
