Cargando…

Fluid-Attenuated Inversion Recovery Hyperintense Vessels in Posterior Cerebral Artery Infarction

BACKGROUND: Fluid-attenuated inversion recovery hyperintense vessels (FHVs) are known to reflect stagnant or slow blood flow within the cerebral artery. FHVs are frequently observed in patients with acute cerebral infarction accompanied by arterial occlusion or significant stenosis of the anterior c...

Descripción completa

Detalles Bibliográficos
Autores principales: Seo, Kwon-Duk, Lee, Kee Oog, Choi, Young-Chul, Kim, Won-Joo, Lee, Kyung-Yul
Formato: Online Artículo Texto
Lenguaje:English
Publicado: S. Karger AG 2013
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3776708/
https://www.ncbi.nlm.nih.gov/pubmed/24052794
http://dx.doi.org/10.1159/000350459
_version_ 1782477512069087232
author Seo, Kwon-Duk
Lee, Kee Oog
Choi, Young-Chul
Kim, Won-Joo
Lee, Kyung-Yul
author_facet Seo, Kwon-Duk
Lee, Kee Oog
Choi, Young-Chul
Kim, Won-Joo
Lee, Kyung-Yul
author_sort Seo, Kwon-Duk
collection PubMed
description BACKGROUND: Fluid-attenuated inversion recovery hyperintense vessels (FHVs) are known to reflect stagnant or slow blood flow within the cerebral artery. FHVs are frequently observed in patients with acute cerebral infarction accompanied by arterial occlusion or significant stenosis of the anterior cerebral circulation. However, FHVs have not been studied in the context of posterior cerebral circulation. Thus, we investigated the prevalence of FHVs and its clinical significance in patients with acute posterior cerebral artery (PCA) territory infarction. METHODS: In this retrospective study, consecutive patients with PCA territory infarction who underwent MRI within 1 week after symptom onset were enrolled. Two neurologists who were blinded to the angiographic findings read the images and determined the presence of FHVs. Afterwards, FHVs were graded according to the extent (subtle or prominent) and location (proximal or distal) of the hyperintense vessels. Neurologic deficits of the patients were assessed by the National Institutes of Health Stroke Scale (NIHSS) upon admission and after 5 days. The clinical outcome between patient groups based on FHVs grading was compared using the NIHSS. Among the patients with PCA occlusion, infarction volume on the diffusion-weighted image was compared between the two groups with and without distal FHVs. RESULTS: FHVs were observed in 25 of the 87 patients (28.7%) with PCA territory infarction and in 65.7% of the 35 patients with significant arterial stenosis (10 patients) or occlusion (25 patients) in the posterior cerebral circulation. Among the 18 patients with PCA occlusion, the NIHSS score was significantly improved in patients with distal FHVs compared to the others (2.00 ± 2.18 vs. 0.56 ± 1.01, p = 0.04). The infarction volume was smaller in the distal FHV group than in the others (8.3 ± 8.7 vs. 16.8 ± 17.6 ml), but the difference was not statistically significant. CONCLUSIONS: FHVs are detected in patients with PCA territory infarction, especially in those with an occlusive lesion in the PCA. FHVs can be used as an imaging marker of PCA occlusion. Although this study showed a better clinical improvement in patients with distal FHVs, further study is needed to elucidate the clinical meaning of FHVs in PCA infarction.
format Online
Article
Text
id pubmed-3776708
institution National Center for Biotechnology Information
language English
publishDate 2013
publisher S. Karger AG
record_format MEDLINE/PubMed
spelling pubmed-37767082013-09-19 Fluid-Attenuated Inversion Recovery Hyperintense Vessels in Posterior Cerebral Artery Infarction Seo, Kwon-Duk Lee, Kee Oog Choi, Young-Chul Kim, Won-Joo Lee, Kyung-Yul Cerebrovasc Dis Extra Original Paper BACKGROUND: Fluid-attenuated inversion recovery hyperintense vessels (FHVs) are known to reflect stagnant or slow blood flow within the cerebral artery. FHVs are frequently observed in patients with acute cerebral infarction accompanied by arterial occlusion or significant stenosis of the anterior cerebral circulation. However, FHVs have not been studied in the context of posterior cerebral circulation. Thus, we investigated the prevalence of FHVs and its clinical significance in patients with acute posterior cerebral artery (PCA) territory infarction. METHODS: In this retrospective study, consecutive patients with PCA territory infarction who underwent MRI within 1 week after symptom onset were enrolled. Two neurologists who were blinded to the angiographic findings read the images and determined the presence of FHVs. Afterwards, FHVs were graded according to the extent (subtle or prominent) and location (proximal or distal) of the hyperintense vessels. Neurologic deficits of the patients were assessed by the National Institutes of Health Stroke Scale (NIHSS) upon admission and after 5 days. The clinical outcome between patient groups based on FHVs grading was compared using the NIHSS. Among the patients with PCA occlusion, infarction volume on the diffusion-weighted image was compared between the two groups with and without distal FHVs. RESULTS: FHVs were observed in 25 of the 87 patients (28.7%) with PCA territory infarction and in 65.7% of the 35 patients with significant arterial stenosis (10 patients) or occlusion (25 patients) in the posterior cerebral circulation. Among the 18 patients with PCA occlusion, the NIHSS score was significantly improved in patients with distal FHVs compared to the others (2.00 ± 2.18 vs. 0.56 ± 1.01, p = 0.04). The infarction volume was smaller in the distal FHV group than in the others (8.3 ± 8.7 vs. 16.8 ± 17.6 ml), but the difference was not statistically significant. CONCLUSIONS: FHVs are detected in patients with PCA territory infarction, especially in those with an occlusive lesion in the PCA. FHVs can be used as an imaging marker of PCA occlusion. Although this study showed a better clinical improvement in patients with distal FHVs, further study is needed to elucidate the clinical meaning of FHVs in PCA infarction. S. Karger AG 2013-04-05 /pmc/articles/PMC3776708/ /pubmed/24052794 http://dx.doi.org/10.1159/000350459 Text en Copyright © 2013 by S. Karger AG, Basel http://creativecommons.org/licenses/by-nc-nd/3.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution-Noncommercial-No-Derivative-Works License (http://creativecommons.org/licenses/by-nc-nd/3.0/). Users may download, print and share this work on the Internet for noncommercial purposes only, provided the original work is properly cited, and a link to the original work on http://www.karger.com and the terms of this license are included in any shared versions.
spellingShingle Original Paper
Seo, Kwon-Duk
Lee, Kee Oog
Choi, Young-Chul
Kim, Won-Joo
Lee, Kyung-Yul
Fluid-Attenuated Inversion Recovery Hyperintense Vessels in Posterior Cerebral Artery Infarction
title Fluid-Attenuated Inversion Recovery Hyperintense Vessels in Posterior Cerebral Artery Infarction
title_full Fluid-Attenuated Inversion Recovery Hyperintense Vessels in Posterior Cerebral Artery Infarction
title_fullStr Fluid-Attenuated Inversion Recovery Hyperintense Vessels in Posterior Cerebral Artery Infarction
title_full_unstemmed Fluid-Attenuated Inversion Recovery Hyperintense Vessels in Posterior Cerebral Artery Infarction
title_short Fluid-Attenuated Inversion Recovery Hyperintense Vessels in Posterior Cerebral Artery Infarction
title_sort fluid-attenuated inversion recovery hyperintense vessels in posterior cerebral artery infarction
topic Original Paper
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3776708/
https://www.ncbi.nlm.nih.gov/pubmed/24052794
http://dx.doi.org/10.1159/000350459
work_keys_str_mv AT seokwonduk fluidattenuatedinversionrecoveryhyperintensevesselsinposteriorcerebralarteryinfarction
AT leekeeoog fluidattenuatedinversionrecoveryhyperintensevesselsinposteriorcerebralarteryinfarction
AT choiyoungchul fluidattenuatedinversionrecoveryhyperintensevesselsinposteriorcerebralarteryinfarction
AT kimwonjoo fluidattenuatedinversionrecoveryhyperintensevesselsinposteriorcerebralarteryinfarction
AT leekyungyul fluidattenuatedinversionrecoveryhyperintensevesselsinposteriorcerebralarteryinfarction