Cargando…

The prominent hypointense vessel sign on susceptibility-weighted imaging (SWI) as a potential imaging biomarker for poor clinical outcome in acute ischemic stroke (AIS)

Susceptibility-weighted imaging (SWI) is a relatively new magnetic resonance imaging (MRI) technique used in the workup and diagnosis of brain pathologies. In the context of acute ischemic stroke (AIS), it is increasingly becoming useful in the diagnosis, treatment, and further management of these p...

Descripción completa

Detalles Bibliográficos
Autores principales: Abdul Rashid, Anna Misyail, Mohd Yaakob, Mohd Naim, Kamis, Mohd Fandi Al-Khafiz, Md Noh, Mohamad Syafeeq Faeez
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9478180/
https://www.ncbi.nlm.nih.gov/pubmed/36120517
http://dx.doi.org/10.1016/j.radcr.2022.08.013
_version_ 1784790510955659264
author Abdul Rashid, Anna Misyail
Mohd Yaakob, Mohd Naim
Kamis, Mohd Fandi Al-Khafiz
Md Noh, Mohamad Syafeeq Faeez
author_facet Abdul Rashid, Anna Misyail
Mohd Yaakob, Mohd Naim
Kamis, Mohd Fandi Al-Khafiz
Md Noh, Mohamad Syafeeq Faeez
author_sort Abdul Rashid, Anna Misyail
collection PubMed
description Susceptibility-weighted imaging (SWI) is a relatively new magnetic resonance imaging (MRI) technique used in the workup and diagnosis of brain pathologies. In the context of acute ischemic stroke (AIS), it is increasingly becoming useful in the diagnosis, treatment, and further management of these patients. An elderly man with metabolic syndrome presented to us with an acute onset of right sided body weakness and aphasia. Urgent imaging via MRI noted a left middle cerebral artery (MCA) occlusion. Diffusion-weighted imaging (DWI)/fluid attenuated inversion recovery (FLAIR) mismatch was noted with an acute infarct involving the left MCA territory; hence, treatment with intravenous (IV) thrombolysis was administered. On SWI, the prominent hypointense vessel sign was noted. Recanalization of the occluded left MCA was seen on diagnostic cerebral angiography post IV thrombolysis, however, the patient was noted to have early neurological deterioration (END) and poor early stage clinical outcome, despite repeat MRI showing recanalization of the left MCA occlusion and reversal of the prominent hypointense vessel sign on SWI. Presence of the prominent hypointense vessel sign on SWI in AIS patients is associated with poor clinical outcome, unsuccessful recanalization rates, END, poor early stage clinical outcome, and infarct core progression. Some studies have shown an association between this imaging sign and poor collateral circulation status. Therefore, this imaging sign could potentially prove to be a useful imaging biomarker. However, more studies are needed to validate this theory.
format Online
Article
Text
id pubmed-9478180
institution National Center for Biotechnology Information
language English
publishDate 2022
publisher Elsevier
record_format MEDLINE/PubMed
spelling pubmed-94781802022-09-17 The prominent hypointense vessel sign on susceptibility-weighted imaging (SWI) as a potential imaging biomarker for poor clinical outcome in acute ischemic stroke (AIS) Abdul Rashid, Anna Misyail Mohd Yaakob, Mohd Naim Kamis, Mohd Fandi Al-Khafiz Md Noh, Mohamad Syafeeq Faeez Radiol Case Rep Case Report Susceptibility-weighted imaging (SWI) is a relatively new magnetic resonance imaging (MRI) technique used in the workup and diagnosis of brain pathologies. In the context of acute ischemic stroke (AIS), it is increasingly becoming useful in the diagnosis, treatment, and further management of these patients. An elderly man with metabolic syndrome presented to us with an acute onset of right sided body weakness and aphasia. Urgent imaging via MRI noted a left middle cerebral artery (MCA) occlusion. Diffusion-weighted imaging (DWI)/fluid attenuated inversion recovery (FLAIR) mismatch was noted with an acute infarct involving the left MCA territory; hence, treatment with intravenous (IV) thrombolysis was administered. On SWI, the prominent hypointense vessel sign was noted. Recanalization of the occluded left MCA was seen on diagnostic cerebral angiography post IV thrombolysis, however, the patient was noted to have early neurological deterioration (END) and poor early stage clinical outcome, despite repeat MRI showing recanalization of the left MCA occlusion and reversal of the prominent hypointense vessel sign on SWI. Presence of the prominent hypointense vessel sign on SWI in AIS patients is associated with poor clinical outcome, unsuccessful recanalization rates, END, poor early stage clinical outcome, and infarct core progression. Some studies have shown an association between this imaging sign and poor collateral circulation status. Therefore, this imaging sign could potentially prove to be a useful imaging biomarker. However, more studies are needed to validate this theory. Elsevier 2022-09-12 /pmc/articles/PMC9478180/ /pubmed/36120517 http://dx.doi.org/10.1016/j.radcr.2022.08.013 Text en © 2022 The Authors. Published by Elsevier Inc. on behalf of University of Washington. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Case Report
Abdul Rashid, Anna Misyail
Mohd Yaakob, Mohd Naim
Kamis, Mohd Fandi Al-Khafiz
Md Noh, Mohamad Syafeeq Faeez
The prominent hypointense vessel sign on susceptibility-weighted imaging (SWI) as a potential imaging biomarker for poor clinical outcome in acute ischemic stroke (AIS)
title The prominent hypointense vessel sign on susceptibility-weighted imaging (SWI) as a potential imaging biomarker for poor clinical outcome in acute ischemic stroke (AIS)
title_full The prominent hypointense vessel sign on susceptibility-weighted imaging (SWI) as a potential imaging biomarker for poor clinical outcome in acute ischemic stroke (AIS)
title_fullStr The prominent hypointense vessel sign on susceptibility-weighted imaging (SWI) as a potential imaging biomarker for poor clinical outcome in acute ischemic stroke (AIS)
title_full_unstemmed The prominent hypointense vessel sign on susceptibility-weighted imaging (SWI) as a potential imaging biomarker for poor clinical outcome in acute ischemic stroke (AIS)
title_short The prominent hypointense vessel sign on susceptibility-weighted imaging (SWI) as a potential imaging biomarker for poor clinical outcome in acute ischemic stroke (AIS)
title_sort prominent hypointense vessel sign on susceptibility-weighted imaging (swi) as a potential imaging biomarker for poor clinical outcome in acute ischemic stroke (ais)
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9478180/
https://www.ncbi.nlm.nih.gov/pubmed/36120517
http://dx.doi.org/10.1016/j.radcr.2022.08.013
work_keys_str_mv AT abdulrashidannamisyail theprominenthypointensevesselsignonsusceptibilityweightedimagingswiasapotentialimagingbiomarkerforpoorclinicaloutcomeinacuteischemicstrokeais
AT mohdyaakobmohdnaim theprominenthypointensevesselsignonsusceptibilityweightedimagingswiasapotentialimagingbiomarkerforpoorclinicaloutcomeinacuteischemicstrokeais
AT kamismohdfandialkhafiz theprominenthypointensevesselsignonsusceptibilityweightedimagingswiasapotentialimagingbiomarkerforpoorclinicaloutcomeinacuteischemicstrokeais
AT mdnohmohamadsyafeeqfaeez theprominenthypointensevesselsignonsusceptibilityweightedimagingswiasapotentialimagingbiomarkerforpoorclinicaloutcomeinacuteischemicstrokeais
AT abdulrashidannamisyail prominenthypointensevesselsignonsusceptibilityweightedimagingswiasapotentialimagingbiomarkerforpoorclinicaloutcomeinacuteischemicstrokeais
AT mohdyaakobmohdnaim prominenthypointensevesselsignonsusceptibilityweightedimagingswiasapotentialimagingbiomarkerforpoorclinicaloutcomeinacuteischemicstrokeais
AT kamismohdfandialkhafiz prominenthypointensevesselsignonsusceptibilityweightedimagingswiasapotentialimagingbiomarkerforpoorclinicaloutcomeinacuteischemicstrokeais
AT mdnohmohamadsyafeeqfaeez prominenthypointensevesselsignonsusceptibilityweightedimagingswiasapotentialimagingbiomarkerforpoorclinicaloutcomeinacuteischemicstrokeais