Imaging Evaluation Of FLAIR Hyperintense Vessel Sign In Acute Cerebral Infraction

Objective To research hyperintense vessel sign on FLAIR(FHV)sequence in acute cerebral infarction within middle cerebral artery blood supply area,and investigating the correlation among FHV sign and clinic NIHSS score after admission,infarction area,stenosis degree and location of responsible vessel,the degree of leukoaraiosis,vein abnormalities on SWI-m IP sequence,blood perfusion state around the infarction area,hemorrhagic transformation and recent prognosis,evaluating the clinic significance of FHV sign in patients with acute cerebral infarction.Materials and methods 67 cases who occurred acute cerebral infarction within 3days after stroke onset and without thrombolysis treatment were collected in our study.All patients underwent MR scan by the Siemens 3.0 T Magneton skyra.imaging sequence included T1 WI,T2WI,DWI,FLAIR,MRA,SWI and ASL,there are 13 patients review second MR scan within 4 to 7 days after admission.These cases were divided into two group included FHV negative group and FHV positive group,according to the presence of FHV sign on FLAIR sequence.Clinical date were obtained in all cases.Calculating the correlation among the two groups and baseline data,NIHSS score after admission,infarction area,stenosis degree and location of responsible vessel,the degree of leukoaraiosis,vein abnormalities,blood perfusion state around the infarction area,hemorrhagic transformation.Evaluating FHV distribution range and vein abnormalities distribution range by ASPECT(FHVASPECT)score in all cases with positive FHV sign.Analyzing the correlation among FHV-ASPECT score and stenosis degree and location of responsible vessel,the degree of leukoaraiosis,abnormal venous ASPECT score.Observing the transformation of FHV in the 13 cases with positive FHV sign on second MR scan,evaluate correlation between FHV sign and the recent program of disease.Results FHV sign was observed 38(56.7%)of 67 enrolled cases.NIHSS score of positive FHV group was higher than that of negative FHV group(P = 0.025 < 0.05).The infarction area of positive FHV group was larger than that of negative FHV group(r = 0.555,P < 0.001).The stenosis degree of responsible vessel in FHV positive group was heavier than that in negative FHV group(r = 0.747,P<0.001),and the higher FHV-ASPECT score,the heavier vascular stenosis degree(r = 0.556,P< 0.001).The stenotic segment of responsible vessel in positive FHV group was closer to the proximal artery than that in negative FHV group(r = 0.614,p = 0.614 <0.05),and the higher FHV-ASPECT score,the closer to the proximal artery vascular of stenotic segment(r = 0.479,P<0.001).The leukoaraiosis degree of positive FHV group was heavier than that of negative FHV group(r = 0.281,P = 0.021 < 0.05),and the higher FHV-ASPECT score,the heavier leukoaraiosis degree(r = 0.363,P =0.025 < 0.05).FHV sign occurred prompted existing of venous anomalies(X2=59.101,P<0.001),and the ASPECT score of them had a good consistency(r = 0.888,P<0.001)."FHV-DWI mismatch area" exist perfusion abnormalities(X2= 19.813,P<0.001),and most of them were hypoperfusion,accounting for 76.5%(26/34).FHV sign occurred had no correlation with intracerebral hemorrhagic transformation in acute stage after infarction(P = 0.393 > 0.05).13 cases with positive FHV reviewed results: no patients with FHV-ASPECT score increased,patients with FHV sign disappeared or FHV-ASPECT score decreased had no recurrence of infarction,and NIHSS score also decreased,patients without decreasing FHV-ASPECT scores,had recurrence of infarction recently,and NIHSS score remained the same or higher.Conclusion In acute cerebral infarction,FHV sign suggest intracranial arteries proximal serious stenosis or occlusion,and cleukoaraiosis degree is relatively heavier.FHV and venous anomalies distribution range has a good consistency,both reflect the hemodynamic changes during brain ischemia.FHV can reflect the blood perfusion around the ischemia area,when the perfusion weighted imaging is unable,FHV sign is benefit for clinical to assess patients condition and guide further treatment.FHV positive patients had larger infarction area and heavier nerve dysfunction,for FHV positive patients,FHV-ASPECT score decreased may suggest relative good prognosis recently.