Intracranial Posterior Circulation Large Artery Thrombi Visualized Using Susceptibility-Weighted MRI

To identify thrombi in patients with posterior circulation large artery occlusion using susceptibility-weighted magnetic resonance imaging (MRI).

All patients hospitalized with intracranial posterior circulation occlusion from January 2003 to September 2013 were included. MRI and computed tomography angiography were reviewed to determine the presence of arterial occlusion and identify thrombi. Eighty-one patients were analyzed to investigate susceptibility vessel sign (SVS) that was identified as blooming artifact (BA) on T2*-weighted gradient echo imaging.

We identified 21 of 63 (33.3%) patients with BA in symptomatic patients, and 1 of 18 (5.6%) in the asymptomatic group with significant difference (P = .019). BAs were found in 6 of 10 (60.0%) patients with cardioembolism, 5 of 13 (38.5%) with dissection, 9 of 34 (26.5%) with large artery atherosclerotic disease, and 1 of 6 (16.7%) with undetermined cause.

Identifying SVS may be useful in exploring the fresh thrombi and the mechanism of posterior circulation stroke.