医学
血栓
闭塞
大脑后动脉
放射科
冲程(发动机)
磁共振成像
脑梗塞
心脏病学
梗塞
磁共振血管造影
磁化率加权成像
内科学
大脑中动脉
心肌梗塞
缺血
机械工程
工程类
作者
Min-Gyu Park,Chang Hyo Yoon,Seung Kug Baik,Kyung-Pil Park
标识
DOI:10.1016/j.jstrokecerebrovasdis.2015.01.021
摘要
Background Susceptibility vessel sign (SVS) on susceptibility-weighted imaging (SWI) has a high sensitivity and specificity to detect the intra-arterial thrombus in anterior circulation stroke. However, SVS has not been evaluated in posterior circulation stroke. Methods We reviewed the data from patients with acute posterior cerebral artery (PCA) infarction within 24 hours from stroke onset. To elucidate the usefulness of SVS for the detection of intraluminal thrombus in acute PCA infarction, the frequency and location of SVS were compared with those of occlusion on magnetic resonance angiography (MRA) and hyperdense PCA sign on computed tomography (CT). Results Twenty-five patients with acute PCA infarction were enrolled in the study. The SVS was found in 92% (23 of 25). MRA showed occlusions in 64% (16 of 25). The SVS was identified in 100% (16 of 16) of patients with occlusion on MRA. Patients without occlusion on MRA also showed the SVS in 78% (7 of 9; P = .0233). The positive SVS without occlusion on MRA was mainly identified in patients with occlusion of distal branches of PCA; P3 segment in 4 and P4 segment in 3. However, the hyperdense PCA sign on CT showed in only 8% (2 of 25) of all patients; its sensitivity was significantly lower than those of the SVS on SWI (P < .001). Conclusions SWI is more sensitive than MRA for the detection of intraluminal thrombus, especially peripheral one, in patients with acute ischemic stroke of the PCA territory. In addition, irrespective of thrombus location, SWI is significantly superior to CT in detecting thrombus in acute PCA infarction. Susceptibility vessel sign (SVS) on susceptibility-weighted imaging (SWI) has a high sensitivity and specificity to detect the intra-arterial thrombus in anterior circulation stroke. However, SVS has not been evaluated in posterior circulation stroke. We reviewed the data from patients with acute posterior cerebral artery (PCA) infarction within 24 hours from stroke onset. To elucidate the usefulness of SVS for the detection of intraluminal thrombus in acute PCA infarction, the frequency and location of SVS were compared with those of occlusion on magnetic resonance angiography (MRA) and hyperdense PCA sign on computed tomography (CT). Twenty-five patients with acute PCA infarction were enrolled in the study. The SVS was found in 92% (23 of 25). MRA showed occlusions in 64% (16 of 25). The SVS was identified in 100% (16 of 16) of patients with occlusion on MRA. Patients without occlusion on MRA also showed the SVS in 78% (7 of 9; P = .0233). The positive SVS without occlusion on MRA was mainly identified in patients with occlusion of distal branches of PCA; P3 segment in 4 and P4 segment in 3. However, the hyperdense PCA sign on CT showed in only 8% (2 of 25) of all patients; its sensitivity was significantly lower than those of the SVS on SWI (P < .001). SWI is more sensitive than MRA for the detection of intraluminal thrombus, especially peripheral one, in patients with acute ischemic stroke of the PCA territory. In addition, irrespective of thrombus location, SWI is significantly superior to CT in detecting thrombus in acute PCA infarction.
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