Zhang Ruiting, Zhou Ying, Liu Chang, Zhang Meixia, Yan Shenqiang, Liebeskind David S, Lou Min
From the Department of Neurology, The Second Affiliated Hospital of Zhejiang University, School of Medicine, Hangzhou, China (R.Z., Y.Z., C.L., M.Z., S.Y., M.L.); and Department of Neurology, University of California-Los Angeles Stroke Center (D.S.L.).
Stroke. 2017 Jul;48(7):1993-1996. doi: 10.1161/STROKEAHA.117.016727. Epub 2017 May 23.
The extent of blooming artifact may reflect the amount of paramagnetic material. We thus assessed the overestimation ratio of susceptibility vessel sign (SVS) on susceptibility-weighted imaging, defined as the extent of SVS width beyond the lumen and examined its value for predicting the stroke cause in acute ischemic stroke patients.
We included consecutive acute ischemic stroke patients with proximal large artery occlusion who underwent both susceptibility-weighted imaging and time-of-flight magnetic resonance angiography within 8 hours poststroke onset. We calculated the length, width, and overestimation ratio of SVS on susceptibility-weighted imaging and then investigated their values for predicting the stroke cause, respectively.
One-hundred eleven consecutive patients (72 female; mean age, 66.6±13.4 years) were enrolled, among whom 39 (35.1%) were diagnosed with cardiogenic embolism, 43 (38.7%) with large artery atherosclerosis, and 29 (26.1%) with undetermined cause. The presence, length, width, and overestimation ratio of SVS were all independently associated with the cause of cardiogenic embolism after adjusting for baseline National Institute of Health Stroke Scale and infarct volume. After excluded patients with undetermined cause, the sensitivity and specificity of overestimation ratio of SVS for cardiogenic embolism were 0.971 and 0.913; for the length of SVS, they were 0.629 and 0.739; for the width of SVS, they were 0.829 and 0.826, respectively.
The overestimation ratio of SVS can predict cardiogenic embolism, with both high sensitivity and specificity, which can be helpful for the management of acute ischemic stroke patients in hyperacute stage.
磁敏感伪影的程度可能反映顺磁性物质的量。因此，我们评估了磁敏感加权成像上磁敏感血管征（SVS）的高估率，其定义为SVS宽度超出管腔的程度，并研究了其对预测急性缺血性卒中患者卒中病因的价值。
我们纳入了连续的近端大动脉闭塞的急性缺血性卒中患者，这些患者在卒中发作后8小时内接受了磁敏感加权成像和时间飞跃磁共振血管造影。我们计算了磁敏感加权成像上SVS的长度、宽度和高估率，然后分别研究它们对预测卒中病因的价值。
共纳入111例连续患者（72例女性；平均年龄66.6±13.4岁），其中39例（35.1%）诊断为心源性栓塞，43例（38.7%）为大动脉粥样硬化，29例（26.1%）病因不明。在校正基线美国国立卫生研究院卒中量表和梗死体积后，SVS的存在、长度、宽度和高估率均与心源性栓塞的病因独立相关。排除病因不明的患者后，SVS高估率对心源性栓塞的敏感性和特异性分别为0.971和0.913；SVS长度的敏感性和特异性分别为0.629和0.739；SVS宽度的敏感性和特异性分别为0.829和0.826。
SVS的高估率可预测心源性栓塞，具有较高的敏感性和特异性，有助于超急性期急性缺血性卒中患者的管理。
