Department of Radiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
Department of Radiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China;Beijing Key Laboratory of Magnetic Resonance Imaging and Brain Informatics, Beijing, China.
Diagn Interv Radiol. 2021 Mar;27(2):285-292. doi: 10.5152/dir.2021.19644.
The prominent vessel sign (PVS) on susceptibility-weighted imaging (SWI) can be dichotomized into prominent cortical veins (PCV) and prominent medullary veins (PMV). This study was designed to compare the predictive value of PCV and PMV in the evaluation of the severity of acute ischemic stroke (AIS) in patients within the reperfusion window.
Forty-seven consecutive patients with AIS within the middle cerebral artery territory were recruited. Magnetic resonance imaging was performed within 8 hours of symptom onset and at 7 days after stroke onset. Infarct volume was measured, and the early clinical outcome at 7 days was assessed using the modified Rankin Scale. PVS was dichotomized into cases with both PCV and PMV and cases with only PCV according to location.
Patients with both PCV and PMV (n=32) had higher admission National Institutes of Health Stroke Scale scores (p = 0.020), larger infarct volumes at baseline (p = 0.026) and 7 days (p = 0.007), and larger infarct growth at 7 days (p = 0.050) than those with PCV only. Multivariate regression analysis showed that both the time of onset at baseline (p = 0.013) and infarct growth at 7 days (p = 0.014) could independently predict poor early clinical outcome.
PMV may predict poor early clinical outcome in AIS patients, and reperfusion therapy may, therefore, be required more urgently in patients with PMV.
磁敏感加权成像（SWI）上的显著血管征（PVS）可分为显著皮质静脉（PCV）和显著髓质静脉（PMV）。本研究旨在比较 PCV 和 PMV 在评估再灌注窗内急性缺血性脑卒中（AIS）患者严重程度中的预测价值。
连续招募 47 例大脑中动脉区域内的 AIS 患者。症状发作后 8 小时内和卒中发作后 7 天进行磁共振成像。测量梗死体积，并使用改良 Rankin 量表评估 7 天的早期临床结局。根据位置将 PVS 分为同时存在 PCV 和 PMV 的病例和仅存在 PCV 的病例。
同时存在 PCV 和 PMV 的患者（n=32）入院时国立卫生研究院卒中量表评分较高（p=0.020），基线时（p=0.026）和 7 天时（p=0.007）梗死体积较大，7 天时梗死体积增大（p=0.050）大于仅存在 PCV 的患者。多变量回归分析显示，基线时发病时间（p=0.013）和 7 天时梗死体积增大（p=0.014）均可独立预测早期临床结局不良。
PMV 可能预测 AIS 患者的不良早期临床结局，因此，PMV 患者可能更需要紧急再灌注治疗。
