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Published in: Neuroradiology 10/2019

01-10-2019 | Stroke | Diagnostic Neuroradiology

Topography of the hyperintense vessel sign on fluid-attenuated inversion recovery represents cerebral hemodynamics in middle cerebral artery occlusion: a CT perfusion study

Authors: Xianjun Huang, Xiaolei Shi, Qian Yang, Yunfeng Zhou, Xiangjun Xu, Junfeng Xu, Xianhui Ding, Zhiming Zhou

Published in: Neuroradiology | Issue 10/2019

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Abstract

Purpose

Whether the topography of fluid-attenuated inversion recovery hyperintense vessel sign (FHVs) can serve as a measure of cerebral hemodynamic stress remains unclear. We hypothesized that FHVs topography represents different cerebral hemodynamic status, as assessed by CT perfusion (CTP).

Methods

We retrospectively reviewed 75 patients with acute middle cerebral artery (MCA) occlusion who underwent MR imaging and CTP. The FHVs topography included FHVs inside the diffusion-weighted imaging (DWI) lesion (FHVs in-group), FHVs outside the DWI lesion (FHVs out-group), and FHVs distributed inside and outside the DWI lesion (FHVs all-group). FHVs scores were assessed by the Alberta stroke program early computed tomography score (ASPECT) territories. Cerebral hemodynamic status was evaluated by relative (r) CTP parameters. Cerebral hemodynamic status was analyzed with respect to different FHVs topographies and FHVs scores.

Results

Hemodynamic impairment was present in all patients, with the following mean rCTP parameters: rCBF, 0.77 ± 0.23; rCBV, 1.06 ± 0.32; and rMTT, 1.52 ± 0.60. Comparison of the rCTP parameters among the three groups, rCBF and rCBV (rCBF, P < 0.001; rCBV, P < 0.001) in the FHVs out-group and the FHVs all-group (rCBF, P = 0.001; rCBV, P < 0.001), were significantly higher than that in the FHVs in-group. Similarly, CTA collateral grade in the FHVs in-group was significantly lower than those in the FHVs out-group and FHVs all-group (P < 0.001). No significant difference was found in rCTP parameters between different FHVs scores.

Conclusion

The different FHVs topographies represented different cerebral hemodynamic status. FHVs topography may serve as a surrogate for patient selection for reperfusion therapy whenever perfusion data are unavailable.
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Metadata
Title
Topography of the hyperintense vessel sign on fluid-attenuated inversion recovery represents cerebral hemodynamics in middle cerebral artery occlusion: a CT perfusion study
Authors
Xianjun Huang
Xiaolei Shi
Qian Yang
Yunfeng Zhou
Xiangjun Xu
Junfeng Xu
Xianhui Ding
Zhiming Zhou
Publication date
01-10-2019
Publisher
Springer Berlin Heidelberg
Published in
Neuroradiology / Issue 10/2019
Print ISSN: 0028-3940
Electronic ISSN: 1432-1920
DOI
https://doi.org/10.1007/s00234-019-02231-y

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