중뇌동맥영역뇌경색환자의FLAIR영상에서보이는동맥내고신호
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Background & Purpose: Arterial occlusion is the major cause of ischemic stroke, and abnormal high signalintensity of the cerebral arteries is frequently seen in ischemic lesion with FLAIR sequences. We attempted toassess the clinical significance of intra-arterial high signal on FLAIR images (IHS-FLAIR). M e t h o d s: IHS-FLAIR was defined as the signal of arterial contour showing high intensity relative to gray matter on FLAIR. Werecruited twenty five patients with acute ischemic stroke in middle cerebral artery territory, who showed IHS-FLAIR. Magnetic resonance images were done within 48 hours after symptom onset and were reviewed in rela-tion to available vascular flow studies, such as MR angiography, conventional angiography, transcranial Ddoppleror SPECT. In addition, we searched the relationship between the presence of IHS-FLAIR and the clinical out-come. Results: All cases with IHS-FLAIR were associated with proximal large vessel occlusion or severe steno-sis. Vascular flow studies revealed perfusion defect on the area related to the distribution of IHS-FLAIR. The areaof IHS-FLAIR distribution is larger than that of infarct lesion on FLAIR or DWI in 13 (52%) patients. 9 (69%)among those 13 patients experienced progression of neurologic symptoms within 48 hours after identification ofIHS-FLAIR. Conclusion: IHS-FLAIR represents distal slow flow due to proximal large vessel occlusion or steno-sis or inadequacy of collateral circulation. It is helpful to predict the area at risk of ischemic injury when the areaof IHS-FLAIR distribution mismatches with that of infarct lesion. 대한뇌졸중학회지제6권제1호2004년5월
Abstract
Background & Purpose: Arterial occlusion is the major cause of ischemic stroke, and abnormal high signalintensity of the cerebral arteries is frequently seen in ischemic lesion with FLAIR sequences. We attempted toassess the clinical significance of intra-arterial high signal on FLAIR images (IHS-FLAIR). M e t h o d s: IHS-FLAIR was defined as the signal of arterial contour showing high intensity relative to gray matter on FLAIR. Werecruited twenty five patients with acute ischemic stroke in middle cerebral artery territory, who showed IHS-FLAIR. Magnetic resonance images were done within 48 hours after symptom onset and were reviewed in rela-tion to available vascular flow studies, such as MR angiography, conventional angiography, transcranial Ddoppleror SPECT. In addition, we searched the relationship between the presence of IHS-FLAIR and the clinical out-come. Results: All cases with IHS-FLAIR were associated with proximal large vessel occlusion or severe steno-sis. Vascular flow studies revealed perfusion defect on the area related to the distribution of IHS-FLAIR. The areaof IHS-FLAIR distribution is larger than that of infarct lesion on FLAIR or DWI in 13 (52%) patients. 9 (69%)among those 13 patients experienced progression of neurologic symptoms within 48 hours after identification ofIHS-FLAIR. Conclusion: IHS-FLAIR represents distal slow flow due to proximal large vessel occlusion or steno-sis or inadequacy of collateral circulation. It is helpful to predict the area at risk of ischemic injury when the areaof IHS-FLAIR distribution mismatches with that of infarct lesion. 대한뇌졸중학회지제6권제1호2004년5월