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Fewer peripheral asymmetrical cortical veins is a predictor of favorable outcome in MCA infarctions with SWI-DWI mismatch.
Journal of Magnetic Resonance Imaging : JMRI 2018 October
BACKGROUND: Outcome prediction of asymmetrical prominent cortical veins (APCVs) on infarction is still debated and may help in selecting patients for reperfusion treatment.
PURPOSE: To explore the relationship between fewer peripheral APCVs and the outcome in the patients of acute/subacute middle cerebral artery (MCA) infarctions as well as the relationship between this sign and stenosis of ipsilateral MCA.
STUDY TYPE: Retrospective case-control study.
POPULATION: We enrolled 41 patients with MCA acute/subacute infarction. Compared to the low sign of cortical veins of contralateral hemisphere on susceptibility-weighted imaging (SWI), these patients were divided into fewer (n = 28) and prominent APCVs (n = 13) groups.
FIELD STRENGTH/SEQUENCE: 3.0T conventional stroke sequences, including T1 -weighted imaging, T2 -weighted imaging, fluid-attenuated inversion recovery (FLAIR), diffusion-weighted imaging (DWI) (b = 0 and 1000 s/mm2 ), MR angiography (MRA), and SWI.
ASSESSMENT: We explored the relationships between fewer peripheral APCVs sign and clinical outcome, as well as the relationship between this sign and the degree of ipsilateral MCA stenosis.
STATISTICAL TESTS: Fisher's exact analysis, logistical regression, as well as Cohen's kappa coefficient were used for statistical analysis.
RESULTS: Fewer and prominent peripheral APCVs were detected in 28 (56.10%) and 13 (43.90%) patients. In 28 patients with fewer peripheral APCVs, 23 patients (82.14%) had a favorable outcome (modified Rankin Scale [mRS] ≤2), and five patients (17.76%) had an unfavorable outcome (mRS >2) (P = 0.010). In terms of MCA stenosis, the rate of normal and mild to moderate stenosis of MCA in the fewer APCVs group (82.14%) was higher than that in the prominent APCVs group (23.08%) (P < 0.001). More severe stenosis of ipsilateral MCA was found in patients with prominent APCVs group (76.92%) than that of fewer APCVs group (17.86%). The peripheral APCVs was positively correlated with the degree of MCA stenosis (r = 0.538, P < 0.001).
DATA CONCLUSION: Fewer peripheral APCVs may suggest a favorable outcome in unilateral MCA infarction. The patency of ipsilateral MCA may correlate to fewer APCVs and favorable outcome.
LEVEL OF EVIDENCE: 3 Technical Efficacy: Stage 5 J. Magn. Reson. Imaging 2018;48:964-970.
PURPOSE: To explore the relationship between fewer peripheral APCVs and the outcome in the patients of acute/subacute middle cerebral artery (MCA) infarctions as well as the relationship between this sign and stenosis of ipsilateral MCA.
STUDY TYPE: Retrospective case-control study.
POPULATION: We enrolled 41 patients with MCA acute/subacute infarction. Compared to the low sign of cortical veins of contralateral hemisphere on susceptibility-weighted imaging (SWI), these patients were divided into fewer (n = 28) and prominent APCVs (n = 13) groups.
FIELD STRENGTH/SEQUENCE: 3.0T conventional stroke sequences, including T1 -weighted imaging, T2 -weighted imaging, fluid-attenuated inversion recovery (FLAIR), diffusion-weighted imaging (DWI) (b = 0 and 1000 s/mm2 ), MR angiography (MRA), and SWI.
ASSESSMENT: We explored the relationships between fewer peripheral APCVs sign and clinical outcome, as well as the relationship between this sign and the degree of ipsilateral MCA stenosis.
STATISTICAL TESTS: Fisher's exact analysis, logistical regression, as well as Cohen's kappa coefficient were used for statistical analysis.
RESULTS: Fewer and prominent peripheral APCVs were detected in 28 (56.10%) and 13 (43.90%) patients. In 28 patients with fewer peripheral APCVs, 23 patients (82.14%) had a favorable outcome (modified Rankin Scale [mRS] ≤2), and five patients (17.76%) had an unfavorable outcome (mRS >2) (P = 0.010). In terms of MCA stenosis, the rate of normal and mild to moderate stenosis of MCA in the fewer APCVs group (82.14%) was higher than that in the prominent APCVs group (23.08%) (P < 0.001). More severe stenosis of ipsilateral MCA was found in patients with prominent APCVs group (76.92%) than that of fewer APCVs group (17.86%). The peripheral APCVs was positively correlated with the degree of MCA stenosis (r = 0.538, P < 0.001).
DATA CONCLUSION: Fewer peripheral APCVs may suggest a favorable outcome in unilateral MCA infarction. The patency of ipsilateral MCA may correlate to fewer APCVs and favorable outcome.
LEVEL OF EVIDENCE: 3 Technical Efficacy: Stage 5 J. Magn. Reson. Imaging 2018;48:964-970.
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