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Ischemic findings of T2*-weighted 3-tesla MRI in acute stroke patients

Naomi Morita1, Masafumi Harada, Masaaki Uno

  • 1Department of Radiology, School of Medicine, University of Tokushima, Tokushima, Japan.

Cerebrovascular Diseases (Basel, Switzerland)
|August 30, 2008
PubMed
Abstract

Insights

Gradient echo T(2)*-weighted MRI signs effectively identify extensive ischemia in acute stroke patients with major vessel occlusion. These findings correlate with hypoperfusion and may indicate severe ischemia.

Area of Science:

  • Neuroimaging
  • Radiology
  • Stroke Imaging

Background:

  • Gradient echo T(2)*-weighted imaging (T(2)*WI) at 3-tesla MRI is utilized to assess acute ischemia.
  • Comparison is made between patients with major vessel occlusion and those with minor infarcts (lacunar or branch atheromatous disease).

Purpose of the Study:

  • To evaluate the utility of specific MRI findings on T(2)*WI in differentiating stroke types.
  • To correlate these findings with perfusion deficits identified by flow-sensitive alternating inversion recovery (FAIR) imaging.

Main Methods:

  • 45 acute stroke patients underwent 3-tesla MRI within 12 hours of symptom onset.
  • Patients were categorized into major vessel occlusion (n=24) or minor infarction (n=21) groups.
  • Vascular ischemic signs (artery susceptibility, cortical vessel, brush signs) and ischemic tissue sign were classified and compared with FAIR-derived hypoperfused areas.

Main Results:

  • Minor infarction patients showed no vascular or ischemic tissue signs on T(2)*WI.
  • Major vessel occlusion patients consistently presented with cortical vessel sign (100%) and brush sign (95.8%).
  • Ischemic tissue sign was observed in 58.3% of major vessel occlusion patients, correlating with greater hypoperfusion on FAIR images.

Conclusions:

  • Ischemic vessel signs and ischemic tissue sign on 3-tesla T(2)*WI are valuable for assessing extensive ischemia in major vessel occlusion stroke.
  • These signs may reflect blood-oxygen-level-dependent effects and severe ischemia, aiding in clinical evaluation.

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