Hunter Medical Research Institute, Newcastle, Australia.
Department of Neurology, John Hunter Hospital, Newcastle, Australia.
PLoS One. 2024 Sep 3;19(9):e0309779. doi: 10.1371/journal.pone.0309779. eCollection 2024.
We aimed to validate hyperintense vessel sign (HVS) on FLAIR imaging or posterior cerebral artery (PCA) laterality on MR angiography beyond 4.5 hours after stroke onset.
Data from acute ischemic stroke patients with internal carotid or middle cerebral artery occlusion who underwent CT perfusion imaging at baseline, follow-up MR perfusion imaging and angiography within 30 hours after stroke, without effective recanalization on follow-up imaging, were analysed retrospectively. Patients were separately classified as high or low HVS (>5 or ≤5 slices of HVS), and PCA laterality positive or negative group. We compared core and penumbra volumes at follow-up imaging and neurological outcomes between high or low HVS group, and between PCA laterality positive or negative group.
Of 49 patients analyzed, four patients with artifacts were excluded and 45 were classified into high (n = 23) or low (n = 22) HVS group. High group had a smaller core volume (median 32 ml versus 109 ml, p = 0.004), larger penumbra volume at follow-up (68 ml versus 0 ml, p = 0.001), and better outcomes (modified Rankin Scale at three months, 3 versus 5, p = 0.03). For PCA laterality analysis, 1 patient with previously occluded PCA was excluded and 48 patients were classified as positive (n = 22) or negative (n = 26). Positive group had larger core volume (116 ml versus 37 ml), and no significant differences in penumbral volumes or outcomes.
Prominent HVS in later time was associated with small core volume, persistent penumbra volume and favorable outcomes.
我们旨在验证卒中后 4.5 小时以上的 FLAIR 成像上的高信号血管征（HVS）或磁共振血管造影上的大脑后动脉（PCA）侧别。
回顾性分析了基底 CT 灌注成像、30 小时内随访磁共振灌注成像和血管造影、无有效再通的颈内或大脑中动脉闭塞的急性缺血性卒中患者的数据。患者分别分为高 HVS（＞5 或 ≤5 个 HVS 层面）和低 HVS 组，以及 PCA 侧别阳性或阴性组。我们比较了随访成像上的核心和半暗带体积以及高或低 HVS 组、PCA 侧别阳性或阴性组之间的神经结局。
在分析的 49 例患者中，有 4 例患者因伪影被排除，45 例患者分为高 HVS 组（n=23）或低 HVS 组（n=22）。高 HVS 组的核心体积较小（中位数 32ml 与 109ml，p=0.004），随访时的半暗带体积较大（68ml 与 0ml，p=0.001），结局更好（3 个月时改良 Rankin 量表，3 与 5，p=0.03）。对于 PCA 侧别分析，排除 1 例之前闭塞的 PCA 患者，48 例患者分为 PCA 侧别阳性组（n=22）或阴性组（n=26）。阳性组的核心体积较大（116ml 与 37ml），半暗带体积和结局无显著差异。
后期明显的 HVS 与小核心体积、持续的半暗带体积和良好的结局相关。
