The association between hyperintense vessel sign and final ischemic lesion differ in its location

Area of Science:

• Neuroimaging
• Cerebrovascular diseases
• Stroke imaging

Background:

• The hyperintense vessel sign (HVS) on fluid-attenuated inversion recovery (FLAIR) MRI is often seen in acute cerebral infarction due to large artery stenosis or occlusion.
• The prognostic implications and clinical characteristics of HVS require further investigation.

Purpose of the Study:

• To assess the association between the hyperintense vessel sign (HVS) and the extent of ischemic lesions.
• To evaluate the relationship of HVS with the severity of neurologic deficits in acute ischemic stroke patients.

Main Methods:

• 96 acute ischemic stroke patients with symptomatic severe middle cerebral artery stenosis/occlusion within 24 hours of onset were analyzed.
• The extent of HVS was quantified using a systematic scoring system (HVS distribution score) based on the Alberta Stroke Program Early Computed Tomographic Score.

Main Results:

• HVS was detected in 93% of patients at admission.
• Wider HVS distribution scores correlated with more severe neurologic deficits (P<.05).
• A strong association was observed between HVS distribution score and final ischemic lesion extent (P<.05), but not in patients who received intravenous thrombolysis (P=.06).

Conclusions:

• The HVS distribution score reflects final ischemic lesion extent in acute ischemic stroke.
• This association may not be applicable to patients treated with thrombolysis.
• Interpretation of HVS distribution scores should consider thrombolysis status.