在超急性期和急性期大面积梗死中，磁敏感加权成像上可见显著低信号血管。

Prominent hypointense vessel on susceptibility-weighted images accompanying hyperacute and acute large infarction.

机构信息

Department of Radiology, Research Institute for Convergence of Biomedical Science and Technology, Pusan National University School of Medicine, Pusan National University Yangsan Hospital, Yangsan, South Korea.

Department of Radiology, Medical Research Institute, Pusan National University School of Medicine, Pusan National University Hospital, Pusan, South Korea.

出版信息

Jpn J Radiol. 2021 Jul;39(7):681-689. doi: 10.1007/s11604-021-01107-7. Epub 2021 Mar 20.

DOI:10.1007/s11604-021-01107-7

PMID:33743148

Abstract

BACKGROUND

Multiple prominent hypointense vessels on susceptibility-weighted image (SWI) have been found in the ischemic territory of patients with acute ischemic stroke. SWI is suitable for venous imaging.

PURPOSE

To evaluate the conditions of prominent hypointense vessel (PHV) in hyperacute and acute cerebral infarctions using susceptibility-weighted image (SWI).

MATERIALS AND METHODS

Magnetic resonance images, including SWI, of 284 patients with acute infarction were evaluated. Based on lesion size, the infarction was classified as a small (< 3 cm) or a large (> 3 cm) infarction. Stage of infarction was classified as hyperacute (< 6 h) or acute (> 6 h, < 1 week) on the basis of the onset of stroke. The site of infarction was categorised as a deep grey matter or a mixed (cortical and/or deep grey matter) infarction. The venous structures were analysed qualitatively for the calibre difference between ipsilateral and contralateral hemispheres. We quantitatively analysed the relationship between the size of areas with PHV on SWI and the abnormalities on MR angiography, apparent diffusion coefficient value, and signal intensity on T2WI in the 271 patients.

RESULTS

PHV over the infarction site was observed in 54.1% (137/253) of the large infarctions, and 19.3% (6/31) of the small infarctions on SWI. PHV was demonstrated in 63.1% (118/187) of mixed infarctions and 25.8% (25/97) of deep grey matter infarctions, and 59.2% (58/98) in hyperacute and 45.7% (85/186) of acute infarctions. The presence of PHV was statistically significant in the size and region of cerebral infarction (p < 0.05), and was not significant in the stage of infarction (p = 0.137). Quantitative analysis revealed significant differences in the MRA abnormalities and ADC values in the PHV ( +) group (p < 0.05) and no significant difference in the T2WI SI ratio in the PHV ( +) group (p = 0.086), compared with PHV (-) group.

CONCLUSION

PHV on SWI was more prominent at the portions with the large and mixed infarctions. PHV was observed both in hyperacute and acute infarction.

摘要

背景

在急性缺血性脑卒中患者的磁敏感加权成像（SWI）缺血区域发现了多个明显的低信号血管。SWI 适用于静脉成像。

目的

使用磁敏感加权成像（SWI）评估超急性和急性脑梗死中明显低信号血管（PHV）的情况。

材料与方法

对 284 例急性梗死患者的磁共振成像（包括 SWI）进行评估。根据病变大小，将梗死分为小梗死（<3cm）和大梗死（>3cm）。根据卒中发病时间，将梗死分为超急性期（<6h）和急性期（>6h，<1 周）。根据梗死部位将梗死分为深部灰质或混合性（皮质和/或深部灰质）梗死。对静脉结构进行定性分析，比较同侧和对侧半球静脉的直径差异。我们在 271 例患者中定量分析了 SWI 上 PHV 区域的大小与磁共振血管造影、表观扩散系数值和 T2WI 信号强度之间的关系。

结果

SWI 上观察到梗死部位的 PHV 见于 54.1%（137/253）的大梗死和 19.3%（6/31）的小梗死。PHV 在 63.1%（118/187）的混合性梗死和 25.8%（25/97）的深部灰质梗死中，63.1%（118/187）见于超急性期和 45.7%（85/186）的急性期。PHV 的存在与脑梗死的大小和部位有统计学意义（p<0.05），与梗死的分期无统计学意义（p=0.137）。定量分析显示，在 PHV（+）组中，MRA 异常和 ADC 值有显著差异（p<0.05），而在 PHV（+）组中，T2WI SI 比值无显著差异（p=0.086）。