Related Experiment Video
Updated: May 20, 2026

Transient Middle Cerebral Artery Occlusion Model of Stroke
Published on: August 11, 2023
M1 susceptibility vessel sign and hyperdense middle cerebral artery sign in hyperacute stroke patients
Yuki Sakamoto1, Kazumi Kimura, Kenichiro Sakai
1Department of Stroke Medicine, Kawasaki Medical School, Kurashiki, Japan. ysakamoto02@gmail.com
Background And Purpose:
Vessel signs, such as the susceptibility vessel sign (SVS) on T2*-gradient echo imaging (T2*) and the hyperdense middle cerebral artery sign (HMCAS) on CT, are well-known markers of arterial occlusion. However, the relationship between the signs is not fully known.
Methods:
Patients suspected of having hyperacute (<3 h from symptom onset) stroke were prospectively enrolled. MRI including T2* and MR angiography, and thin-section CT were performed on admission. The consistency between SVS and HMCAS were evaluated.
Results:
A total of 67 patients [38 males, median age: 76 (interquartile range: 67-82) years, median NIHSS score: 12 (4-21)] were enrolled. SVS was observed in 6 patients (9%), and HMCAS was present in 8 (12%). Sixteen patients (24%) had middle cerebral artery proximal (M1) occlusion on MR angiography. The presence or absence of SVS was highly consistent with that of HMCAS when all cases were evaluated (ĸ = 0.841), as well as when only patients with M1 occlusion were assessed (ĸ = 0.750).
Conclusion:
SVS and HMCAS were highly consistent with each other in suspected hyperacute stroke patients. SVS and HMCAS may represent the same thrombus.
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