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European Radiology
Published in: European Radiology 9/2019

01-09-2019 | Magnetic Resonance Imaging | Head and Neck

FLAIR vascular hyperintensity in acute stroke is associated with collateralization and functional outcome

Authors: Liang Jiang, Yu-Chen Chen, Hong Zhang, Mingyang Peng, Huiyou Chen, Wen Geng, Quan Xu, Xindao Yin, Yuehu Ma

Published in: European Radiology | Issue 9/2019

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Abstract

Purpose

Fluid-attenuated inversion recovery vascular hyperintensity (FVH) is frequently found in stroke patients after intracranial arterial occlusion, but the prognostic value of FVH findings is unclear. We assessed whether FVH is associated with cerebral collateral status and functional outcome in patients with acute stroke patients receiving endovascular therapy.

Methods

FVH score, American Society of Interventional and Therapeutic Neuroradiology (ASITN) grade, the functional outcome at 3 months (modified Rankin Scale (mRS)), and other clinical data were collected for 37 acute stroke patients with large vessel occlusion (LVO) receiving MRI before and after endovascular therapy. Statistical analysis was performed to predict functional outcome after stroke.

Results

The good functional outcome group (n = 16) had a higher FVH1 (FVH before therapy) score (4.63 ± 1.20 vs 3.14 ± 1.15; p = 0.001) and ASITN grade (3.31 ± 0.48 vs 2.00 ± 1.22; p < 0.001) and a lower FVH2 (FVH after therapy) score than the poor functional outcome group (n = 21; 0.125 ± 0.50 vs 1.44 ± 2.16; p = 0.030). mRS at 3 months was negatively correlated with FVH1 (r = − 0.525, p = 0.001) and the ASITN grade (r = − 0.478, p = 0.003) and positively correlated with FVH2 (r = 0.376, p = 0.034). FVH1 (OR, 0.085; 95% CI, 0.013–0.577; p = 0.012) and FVH2 (OR, 2.724; 95% CI, 1.061–6.996; p = 0.037) were independently associated with functional outcome in multivariable logistic regression analysis.

Conclusions

Assessing FVH before and after therapy in acute stroke patients with LVO might be useful for predicting functional outcome after stroke.

Key Points

• Fluid-attenuated inversion recovery vascular hyperintensity is a circular or serpentine brightening in the brain parenchyma or cortical surface bordering the subarachnoid space on MR imaging.
• A prospective study showed that fluid-attenuated inversion recovery vascular hyperintensity is associated with cerebral collateral circulation and prognosis.
• Fluid-attenuated inversion recovery vascular hyperintensity helps clinicians to predict the prognosis of patients with acute stroke.
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Metadata
Title
FLAIR vascular hyperintensity in acute stroke is associated with collateralization and functional outcome
Authors
Liang Jiang
Yu-Chen Chen
Hong Zhang
Mingyang Peng
Huiyou Chen
Wen Geng
Quan Xu
Xindao Yin
Yuehu Ma
Publication date
01-09-2019
Publisher
Springer Berlin Heidelberg
Published in
European Radiology / Issue 9/2019
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-019-06022-0

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