Université Caen-Normandie, INSERM UMR-S U1237, Cyceron, Caen, France (S.S., M.G., M.Z., E.T.).
Neuroradiology, Hôpital Maison Blanche, CHU Reims, France (S.S., P.-F.M., T.H., L.P.).
Stroke. 2021 May;52(5):1839-1842. doi: 10.1161/STROKEAHA.120.032198. Epub 2021 Apr 8.
In acute ischemic stroke, the susceptibility vessel sign (SVS) on T2* MR-sequence witnesses the red blood cell content of the clot. Although clot composition strongly depends on its age in vitro, the relationship between SVS and time has not been studied. In this study, we evaluated whether the presence of SVS was related to the time from symptom onset.
We retrospectively analyzed our institutional registry of patients with acute stroke between November 2007 and June 2018. We included patients with an ischemic stroke confirmed by diffusion-weighted imaging magnetic resonance imaging within 8 hours from symptom onset caused by M1 or M2 occlusion and with interpretable T2*-weighted images. We compared clinical and imaging variables among SVS+ and SVS− patients. Time from onset was split into tertiles. Independent markers of SVS+ were identified using multivariable logistic regression. The probability of being SVS+ given time from symptoms onset was modeled using Probit regression.
Among the 608 patients included, 433 (71.2%) were SVS+. The odds of being SVS+ increased with time from symptom onset (P trend=0.005). In the multivariable analysis, factors independently associated with a SVS+ were symptom onset to magnetic resonance imaging ([130–180 min] odds ratio [OR], 1.62 [95% CI, 1.03–2.53]; [>180 min] OR, 3.14 [95% CI, 1.92–5.12]), type of magnetic resonance imaging-scanner (OR, 2.83 [95% CI, 1.82–4.41]), cardioembolic cause (OR, 1.51 [95% CI, 1.02–2.24]), and baseline National Institutes of Health Stroke Scale (OR, 1.05 [95% CI, 1.01–1.08]). The probability of being SVS+ increased with time from symptom onset (P=0.004): around 60% at 1 hour, 70% at 3 hours, 80% at 6 hours, and 90% at 8 hours.
In acute ischemic stroke, the presence of SVS depends on time from onset to imaging.
在急性缺血性脑卒中患者中，T2*MR 序列上的易损血管征（SVS）反映了血栓中的红细胞含量。尽管血栓的组成在体外强烈依赖于其年龄，但 SVS 与时间之间的关系尚未得到研究。在本研究中，我们评估了 SVS 的存在是否与症状发作后的时间有关。
我们回顾性分析了 2007 年 11 月至 2018 年 6 月我院急性脑卒中患者的登记资料。纳入了在症状发作后 8 小时内通过弥散加权成像磁共振成像证实的由 M1 或 M2 闭塞引起的缺血性脑卒中患者，且 T2*-加权图像可解释。我们比较了 SVS+和 SVS-患者的临床和影像学变量。将发病时间分为三分位。使用多变量逻辑回归确定 SVS+的独立标志物。使用概率回归模型分析 SVS+的概率。
在 608 例患者中，433 例（71.2%）为 SVS+。SVS+的可能性随症状发作后时间的延长而增加（P 趋势=0.005）。多变量分析显示，与 SVS+独立相关的因素包括症状发作至磁共振成像时间（[130-180 min]比值比[OR]，1.62[95%可信区间，1.03-2.53]；[>180 min]OR，3.14[95%可信区间，1.92-5.12]）、磁共振成像扫描仪类型（OR，2.83[95%可信区间，1.82-4.41]）、心源性栓塞病因（OR，1.51[95%可信区间，1.02-2.24]）和基线国立卫生研究院卒中量表（OR，1.05[95%可信区间，1.01-1.08]）。SVS+的概率随症状发作后时间的延长而增加（P=0.004）：1 小时时约为 60%，3 小时时约为 70%，6 小时时约为 80%，8 小时时约为 90%。
在急性缺血性脑卒中患者中，SVS 的存在取决于从发病到成像的时间。
