Top

Neuroradiology

Published in:

01-05-2012 | Diagnostic Neuroradiology

Changes in susceptibility signs on serial T2*-weighted single-shot echo-planar gradient-echo images in acute embolic infarction: comparison with recanalization status on 3D time-of-flight magnetic resonance angiography

Authors: Yuki Shinohara, Toshibumi Kinoshita, Fumiko Kinoshita

Published in: Neuroradiology | Issue 5/2012

Abstract

Introduction

The present study compares changes in susceptibility signs on follow-up single-shot echo-planar gradient-echo T2*-weighted images (GRE-EPI) with vascular status on follow-up magnetic resonance angiography (MRA) in acute embolic infarction.

Methods

Twenty consecutive patients with acute embolic infarction repeatedly underwent MR imaging including GRE-EPI and MRA using a 1.5-T MR superconducting system. All patients underwent initial MR examination within 24 h of onset and follow-up MR imaging within 1 month after onset.

Results

Changes in susceptibility signs on follow-up GRE-EPI were compatible with vascular status on follow-up MRA in 19 of the 20 patients. Susceptibility signs disappeared with complete recanalization in 13 patients, migrated with partial recanalization in 3, did not change together with the absence of recanalization in 2, and became extended together with the absence of recanalization in 1. Cerebral hemorrhage obscured susceptibility signs in the one remaining patient.

Conclusion

Susceptibility signs on follow-up GRE-EPI can reflect changes in an acute embolus, such as recanalization or migration, in this study. Serial GRE-EPI in acute embolism complements the diagnostic certainty of MRA by directly detecting an embolus as a susceptibility sign.

Kim HS, Lee DH, Choi CG, Kim SJ, Suh DC (2006) Progression of middle cerebral artery susceptibility sign on T2*-weighted images: its effect on recanalization and clinical outcome after thrombolysis. AJR Am J Roentgenol 187:650–657CrossRef

Assouline E, Benziane K, Reizine D, Guichard JP, Pico F, Merland JJ, Bousser MG, Chabriat H (2005) Intra-arterial thrombus visualized on T2* gradient echo imaging in acute ischemic stroke. Cerebrovasc Dis 20:6–11PubMedCrossRef

Kinoshita T, Okudera T, Tamura H, Ogawa T, Hatazawa J (2000) Assessment of lacunar hemorrhage associated with hypertensive stroke by echo-planar gradient-echo T2*-weighted MRI. Stroke 31:1646–1650PubMedCrossRef

Linfante I, Llinas RH, Caplan LR, Warach S (1999) MRI features of intracerebral hemorrhage within 2 hours from symptom onset. Stroke 30:2263–2267PubMedCrossRef

Flacke S, Urbach H, Keller E, Träber F, Hartmann A, Textor J, Gieseke J, Block W, Folkers PJ, Schild HH (2000) Middle cerebral artery (MCA) susceptibility sign at susceptibility-based perfusion MR imaging: clinical importance and comparison with hyperdense MCA sign at CT. Radiology 215:476–482PubMed

Schellinger PD, Chalela JA, Kang DW, Latour LL, Warach S (2005) Diagnostic and prognostic value of early MR imaging vessel signs in hyperacute stroke patients imaged <3 hours and treated with recombinant tissue plasminogen activator. AJNR Am J Neuroradiol 26:618–624PubMed

Rovira A, Orellana P, Alvarez-Sabín J, Arenillas JF, Aymerich X, Grivé E, Molina C, Rovira-Gols A (2004) Hyperacute ischemic stroke: middle cerebral artery susceptibility sign at echo-planar gradient-echo MR imaging. Radiology 232:466–473PubMedCrossRef

Cho KH, Kim JS, Kwon SU, Cho AH, Kang DW (2005) Significance of susceptibility vessel sign on T2*-weighted gradient echo imaging for identification of stroke subtypes. Stroke 36:2379–2383PubMedCrossRef

Teitelbaum GP, Ortega HV, Vinitski S, Clark RA, Watanabe AT, Matsumoto AH, Rifkin MD, Barth KH (1990) Optimization of gradient-echo imaging parameters for intracaval filters and trapped thromboemboli. Radiology 174:1013–1019PubMed

10.

Atlas SW, Thulborn KR (1998) MR detection of hyperacute parenchymal hemorrhage of the brain. AJNR Am J Neuroradiol 19:1471–1477PubMed

11.

del Zoppo GJ, Poeck K, Pessin MS, Wolpert SM, Furlan AJ, Ferbert A, Alberts MJ, Zivin JA, Wechsler L, Busse O, Greenlee R Jr, Brass L, Mohr JP, Feldmann E, Hacke W, Kase CS, Biller J, Gress D, Otis SM (1992) Recombinant tissue plasminogen activator in acute thrombotic and embolic stroke. Ann Neurol 32:78–86PubMedCrossRef

12.

Liang L, Korogi Y, Sugahara T, Shigematsu Y, Okuda T, Ikushima I, Takahashi M (1999) Detection of intracranial hemorrhage with susceptibility-weighted MR sequences. AJNR Am J Neuroradiol 20:1527–1534PubMed

13.

Lansberg MG, Thijs VN, Bammer R, Kemp S, Wijman CA, Marks MP, Albers GW, DEFUSE Investigators (2007) Risk factors of symptomatic intracerebral hemorrhage after tPA therapy for acute stroke. Stroke 38:2275–2278PubMedCrossRef

14.

Kimura K, Iguchi Y, Shibazaki K, Kobayashi K, Uemura J, Aoki J, Yamashita S, Terasawa Y, Matsumoto N (2008) Recanalization between 1 and 24 hours after t-PA therapy is a strong predictor of cerebral hemorrhage in acute ischemic stroke patients. J Neurol Sci 270:48–52PubMedCrossRef

15.

Morita N, Harada M, Uno M, Matsubara S, Matsuda T, Nagahiro S, Nishitani H (2008) Ischemic findings of T2*-weighted 3-Tesla MRI in acute stroke patients. Cerebrovasc Dis 26:367–375PubMedCrossRef

16.

Hirai T, Korogi Y, Ono K, Nagano M, Maruoka K, Uemura S, Takahashi M (2002) Prospective evaluation of suspected stenoocclusive disease of the intracranial artery: combined MR angiography and CT angiography compared with digital subtraction angiography. AJNR Am J Neuroradiol 23:93–101PubMed

17.

Stock KW, Wetzel S, Kirsch E, Bongartz G, Steinbrich W, Radue EW (1996) Anatomic evaluation of the circle of Willis: MR angiography versus intraarterial digital subtraction angiography. AJNR Am J Neuroradiol 17:1495–1499PubMed

Title: Changes in susceptibility signs on serial T2*-weighted single-shot echo-planar gradient-echo images in acute embolic infarction: comparison with recanalization status on 3D time-of-flight magnetic resonance angiography
Authors: Yuki Shinohara
Toshibumi Kinoshita
Fumiko Kinoshita
Publication date: 01-05-2012
Publisher: Springer-Verlag
Published in: Neuroradiology / Issue 5/2012
Print ISSN: 0028-3940
Electronic ISSN: 1432-1920
DOI: https://doi.org/10.1007/s00234-011-0895-6

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Changes in susceptibility signs on serial T2*-weighted single-shot echo-planar gradient-echo images in acute embolic infarction: comparison with recanalization status on 3D time-of-flight magnetic resonance angiography

Abstract

Introduction

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Introduction

Methods

Results

Conclusion

Please log in to get access to this content

Other articles of this Issue 5/2012

Quantitative multivoxel proton MR spectroscopy study of brain metabolites in patients with amnestic mild cognitive impairment: a pilot study

Congenital external carotid–internal carotid artery anastomosis associated with contralateral non-bifurcating cervical carotid artery

Assessment of pituitary adenoma volumetric change using longitudinal MR image registration

Fenestrations of the intracranial vertebrobasilar system diagnosed by MR angiography

European Society of Neuroradiology (ESNR)

CT and MR perfusion can discriminate severe cerebral hypoperfusion from perfusion absence: evaluation of different commercial software packages by using digital phantoms