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Thrombus Length Estimation on Delayed Gadolinium-Enhanced T1.

Shenqiang Yan1, Qingmeng Chen1, Mengjun Xu1

  • 1From the Department of Neurology (S.Y., Q.C., M.X., M.L.) and Radiology (J.S.), The 2nd Affiliated Hospital of Zhejiang University, School of Medicine, Hangzhou, China; and Department of Neurology, University of California-Los Angeles Stroke Center (D.S.L.).

Stroke
|January 16, 2016
PubMed
Summary

Delayed gadolinium-enhanced T1 (dGE-T1) MRI can predict recanalization after intravenous thrombolysis (IVT) in stroke patients. Thrombus length measured on dGE-T1 helps assess treatment outcomes and guide clinical decisions.

Keywords:
artifactmagnetic resonance imagingmiddle cerebral arterystrokethrombolytic therapy

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Area of Science:

  • Neurology
  • Radiology
  • Cardiovascular Medicine

Background:

  • Thrombus length is linked to recanalization rates after intravenous thrombolysis (IVT).
  • Assessing thrombus length is crucial for predicting stroke treatment outcomes.

Purpose of the Study:

  • To evaluate the predictive value of thrombus length, measured using delayed gadolinium-enhanced T1 (dGE-T1) MRI, for middle cerebral artery recanalization after IVT.
  • To introduce dGE-T1 as a novel imaging technique for thrombus assessment.

Main Methods:

  • Prospective collection of clinical and multimodal MRI data from acute ischemic stroke patients with middle cerebral artery occlusion.
  • Measurement of thrombus length on dGE-T1 MRI sequences obtained before and after IVT.
  • Statistical analysis to examine the association between dGE-T1 thrombus length and middle cerebral artery recanalization.

Main Results:

  • Thrombus length on dGE-T1 was an acceptable predictor of no recanalization (OR, 1.196; P=0.033).
  • An optimal cut-off of 6.77 mm showed 77.8% sensitivity and 57.9% specificity for predicting recanalization (OR, 4.81; P=0.002).
  • No recanalization occurred when thrombus length exceeded 14 mm on dGE-T1.

Conclusions:

  • Delayed gadolinium-enhanced T1 (dGE-T1) MRI is a valuable tool for estimating thrombus length.
  • dGE-T1 imaging can effectively predict middle cerebral artery recanalization after IVT.
  • Simple adjustment of scanning order in MRI protocols enhances thrombus assessment capabilities.