Investigative Magnetic Resonance Imaging

Korean Society of Magnetic Resonance in Medicine (대한자기공명의과학회)
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Susceptibility Vessel Sign for the Detection of Hyperacute MCA Occlusion: Evaluation with Susceptibility-weighted MR Imaging

  • Lee, Sangmin (Department of Radiology, Gyeongsang National University School of Medicine) ;
  • Cho, Soo Bueum (Department of Radiology, Gyeongsang National University School of Medicine) ;
  • Choi, Dae Seob (Department of Radiology, Gyeongsang National University School of Medicine) ;
  • Park, Sung Eun (Department of Radiology, Gyeongsang National University School of Medicine) ;
  • Shin, Hwa Seon (Department of Radiology, Gyeongsang National University School of Medicine) ;
  • Baek, Hye Jin (Department of Radiology, Gyeongsang National University School of Medicine) ;
  • Choi, Ho Cheol (Department of Radiology, Gyeongsang National University School of Medicine) ;
  • Kim, Ji-Eun (Department of Radiology, Gyeongsang National University School of Medicine) ;
  • Choi, Hye Young (Department of Radiology, Gyeongsang National University School of Medicine) ;
  • Park, Mi Jung (Department of Radiology, Gyeongsang National University School of Medicine)
  • Received : 2016.06.18
  • Accepted : 2016.06.21
  • Published : 2016.06.30
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Abstract

Purpose: Susceptibility vessel sign (SVS) on gradient echo image, which is caused by MR signal loss due to arterial thrombosis, has been reported in acute middle cerebral artery (MCA) infarction. However, the reported sensitivity and diagnostic accuracy of SVS have been variable. Susceptibility-weighted imaging (SWI) is a newly developed MR sequence. Recent studies have found that SWI may be useful in the field of cerebrovascular diseases, especially for detecting the presence of prominent veins, microbleeds and the SVS. The purpose of this study was to evaluate the diagnostic values of SWI for the detection of hyperacute MCA occlusion. Materials and Methods: Sixty-nine patients (37 males, 32 females; 46-89 years old [mean, 69.1]) with acute stroke involving the MCA territory underwent MR imaging within 6 hours after the symptom onset. MR examination included T2, FLAIR (fluid-attenuated inversion recovery), DWI, SWI, PWI (perfusion-weighted imaging), contrast-enhanced MR angiography (MRA) and contrast-enhanced T1. Of these patients, 28 patients also underwent digital subtraction angiography (DSA) within 2 hours after MR examination. Presence or absence of SVS on SWI was assessed without knowledge of clinical, DSA and other MR imaging findings. Results: On MRA or DSA, 34 patients (49.3%) showed MCA occlusion. Of these patients, SVS was detected in 30 (88.2%) on SWI. The sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy of SWI were 88.2%, 97.1%, 96.8%, 89.5% and 92.8%, respectively. Conclusion: SWI was sensitive, specific and accurate for the detection of hyperacute MCA occlusion.

Keywords

References

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