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Clinical Article
Analysis of related factors and prognosis of FLAIR vascular hyperintensity sign in acute ischemic stroke
HAN Na  MA Yurong  LI Xiaoyan  LI Jiachen  CHENG Xiu  ZHANG Jing 

Cite this article as: Han N, Ma YR, Li XY, et al. Analysis of related factors and prognosis of FLAIR vascular hyperintensity sign in acute ischemic stroke. Chin J Magn Reson Imaging, 2020, 11(3): 177-182. DOI:10.12015/issn.1674-8034.2020.03.004.


[Abstract] Objective: To investigate related factors of fluid attenuated inversion recovery vascular hyperintensity (FVH) in patients with acute ischemic stroke (AIS) in middle cerebral artery (MCA), and whether FVH associated with stroke outcome.Materials and Methods: Retrospectively analyzed the clinical and imaging datas of 276 patients with MCA territory AIS (from September 2016 to March 2019). The patients were divided into FVH positive group and negative group. FVH positive group was divided into 3 grades according to the distribution of FVH. In addition, after treatment, 22 patients with grade 3 vascular stenosis in the FVH-positive group completed followup MR examination at7 days after stroke onset, and completed modified Rankin Scale (mRS) evaluation at 90 days. According to the follow up MRA appearance, patients were divided into two groups: vascular recanalization group and non-vascular recanalization group. According to the mRS at 90 days, patients were divided into two groups: good outcome group (mRS≤2) and poor outcome group (mRS> 2). The χ2 test and Fisher's exact test were used to analyze clinical and imaging factors affecting the appear and grade of FVH. Fisher's exact test was used to analyze the disappearance of FVH between the vascular recanalization group and non-vascular recanalization group, as well as the baseline FVH level, the disappearance of FVH and the vascular recanalization after treatment between the good and poor outcome group. The t-test was used to analyze the difference in baseline NIHSS score between the good and poor outcome group.Results: There were no significant differences in age, gender, stroke risk factors and Willis circle classification among the FVH positive and negative groups. The occurrence of FVH was related to the onset-MR examination time, vascular stenosis location, degree and infarct size (P=0.011, P=0.011, P=0.000, P=0.000). The difference between FVH grades and infarct size was statistically significant (χ2=7.026, P=0.030). Among the 22 patients, the difference was statistically significant in the disappearance of FVH between the vascular recanalization and non-recanalization group (P=0.000).There were significant differences in baseline NIHSS scores and disappearance of FVH after treatment between the good and poor outcome group (P=0.000, P=0.002), no significant differences in baseline FVH level and vascular recanalization after treatment between the two groups (P=0.290, P=0.080).Conclusions: The patients onset-MR examination time, the location and degree of the vascular stenosis were the important factors that affected the occurrence of FVH, and the disappearance of FVH after treatment could be used to predict the recanalization of the occlusive vascular. The patient's outcome is related to the baseline NIHSS score and disappearance of FVH after treatment, low baseline NIHSS score and disappearance of FVH after treatment suggest a good outcome.
[Keywords] acute ischemic stroke;fluid attenuated inversion recovery;vascular hyperintensity sign;magnetic resonance imaging

HAN Na Department of Magnetic Resonance, Lanzhou University Second Hospital, Lanzhou 730000, China

MA Yurong Department of Magnetic Resonance, Lanzhou University Second Hospital, Lanzhou 730000, China

LI Xiaoyan Department of Magnetic Resonance, Yuzhong County First People's Hospital, Yuzhong 730100, China

LI Jiachen Department of Magnetic Resonance, Lanzhou University Second Hospital, Lanzhou 730000, China

CHENG Xiu Department of Magnetic Resonance, Lanzhou University Second Hospital, Lanzhou 730000, China

ZHANG Jing* Department of Magnetic Resonance, Lanzhou University Second Hospital, Lanzhou 730000, China

*Correspondence to: Zhang J, E-mail: lztong2001 @163.com

Conflicts of interest   None.

ACKNOWLEDGMENTS  Health Industry Scientific Research Program Project of Gansu Province No. GSWSKY-2019-09
Received  2019-12-01
Accepted  2020-02-12
DOI: 10.12015/issn.1674-8034.2020.03.004
Cite this article as: Han N, Ma YR, Li XY, et al. Analysis of related factors and prognosis of FLAIR vascular hyperintensity sign in acute ischemic stroke. Chin J Magn Reson Imaging, 2020, 11(3): 177-182. DOI:10.12015/issn.1674-8034.2020.03.004.

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