| Objective: To study the clinical application value of intravascular hyperintense sign on T2-weighed image(T2WI)in diagnosing thrombosis of internal carotid artery(ICA),evaluating the condition and prognosis of patients with acute ischemia stroke(ACI).Methods: From January 2016 to August 2018,patients with anterior circulation territory ischemic stroke within 48 hours of symptom onset were retrospectively reviewed in the second affiliated hospital of Nanchang University.All of patients were imaged with magnetic resonance imaging(MRI),diffusion-weighted imaging(DWI)and magnetic resonance angiography(MRA)through 3.0T MRI system.We defined the manifestation on imaging of our patients which flow-void signals of the responsible ICA disappeared and was replaced by intravascular hyperintense signs on T2 WI as T2 sequence-hyperintense vessels(T2HVS).T2 HVS positive group included these patients whose responsible ICA presented T2 HVS and MRA further confirmed that corresponding ICA with severe stenosis or occlusion,while those with negative T2 HVS in the responsible ICA and normal arteries of anterior circulation on MRA were included in the T2 HVS negative group.We speculate that T2 HVS may be regarded as an imaging marker of arterial thrombosis,and further explore the relationship among T2 HVS and clinical condition and short-term prognosis.Results: Of the 133 hospitalized patients who met the inclusion criteria,they were composed of 61 women and 72 men with a mean age of(65±12)years(range 21 to 87).Imaging of 58 cases showed T2 HVS,The positive rate of T2 HVS was 46.3%(58/133).Moreover,in T2 HVS group,after average 6.5 months of following-up brain MRI,the T2 HVS of the affected ICA disappeared in four patients and was replaced by the flow-void signal,which is same to vessel signal of contralateral normal ICA.There were no significant differences in baseline characteristics between T2 HVS positive and negative group,including sex(P =0.642),age(P =0.083),onset to hospital arrival(P =0.232),onset to MRI(P =0.079),hypertension(P =0.740),diabetes(P =0.333),hyperlipidemia(P =0.253),smoking(P =0.669),and history of a stroke or TIA(P =0.985).It was significantly different between two groups in structural heart diseases(P=0.002),especially in atrial fibrillation(AF,P=0.000).Binary logistic analysis showed that there was no significant correlation between structural heart disease and T2HVS(OR=1.171,P=0.808),but atrial fibrillation(AF)was closely related with T2HVS(OR=0.193,P=0.010).There were significant differences in NIHSS at admission(P=0.000)and mRS at discharge(P=0.000)between positive and negative T2 HVS group.Spearman correlation analysis suggested that both NIHSS at admission(r=-0.648,P=0.000)and short-term prognosis(r=-0.704,P=0.000)are closely correlated with T2 HVS.Conclusions: T2 HVS can be regarded as imaging marker of arterial thrombosis,and provides objective imaging evidences for clinician to choose appropriate clinical treatment,to evaluate condition and prognosis of patients in acute ischemic stroke. |
