Department of Neurology, Jinling Hospital, Nanjing University School of Medicine, Nanjing, China.
Eur Neurol. 2012;68(4):214-20. doi: 10.1159/000340021. Epub 2012 Sep 4.
Hyperintense vessels (HVs) on fluid-attenuated inversion recovery (FLAIR) are frequently observed in acute ischemic stroke (AIS). The presence of HVs represents altered blood flow from collaterals distal to arterial occlusion or stenosis. This study aimed to evaluate the prognostic value of HVs in AIS.
Fifty-four consecutive patients with acute middle cerebral artery occlusion were enrolled in the study. The location and extent of the HVs was determined by FLAIR. Clinical data were obtained and compared between patients with different grades of HVs. Additionally, the relationship between distal HVs and leptomeningeal collaterals (LMCs) was assessed using angiography.
HVs were observed in 41 (75.9%) of the 54 patients enrolled. The initial NIHSS score was lower (p<0.001) and the infarction volume was smaller (p<0.001) in patients with distal HVs. Adjusting of other factors, regression analysis revealed that distal HVs are an independent predictor of a favorable outcome at 90 days (p=0.006; OR 0.049; 95% CI 0.006-0.420). Furthermore, the presence of distal HVs was correlated with the presence of LMCs.
Distal HVs may be a marker for LMCs and act as a predictor of a favorable clinical outcome for patients with AIS.
在液体衰减反转恢复（FLAIR）上观察到高信号血管（HV）是急性缺血性脑卒中（AIS）的常见表现。HV 的存在代表了动脉闭塞或狭窄远端侧支循环的血流改变。本研究旨在评估 HV 在 AIS 中的预后价值。
本研究纳入了 54 例连续的急性大脑中动脉闭塞患者。通过 FLAIR 确定 HV 的位置和程度。比较不同 HV 程度患者的临床数据。此外，还通过血管造影评估远端 HV 与软脑膜侧支循环（LMCs）之间的关系。
54 例患者中，41 例（75.9%）观察到 HV。远端 HV 患者的初始 NIHSS 评分较低（p<0.001），梗死体积较小（p<0.001）。调整其他因素后，回归分析显示远端 HV 是 90 天时良好预后的独立预测因素（p=0.006；OR 0.049；95% CI 0.006-0.420）。此外，远端 HV 的存在与 LMCs 的存在相关。
远端 HV 可能是 LMCs 的标志物，并作为 AIS 患者良好临床预后的预测因子。
