Fewer peripheral asymmetrical cortical veins is a predictor of favorable outcome in MCA infarctions with SWI‐DWI mismatch. Issue 4 (9th February 2018)

• Record Type: Journal Article
• Authors: Yuan, Tao; Ren, Guoli; Quan, Guanmin; Gao, Duo
• Is Part Of: Journal of magnetic resonance imaging. Volume 48:Issue 4(2018)
• Page Start: 964
• Page End: 970
• Publication Date: 2018-02-09
• Subjects: cerebral infarction -- middle cerebral artery -- magnetic resonance imaging -- susceptibility‐weighted imaging -- prognosis; Magnetic resonance imaging -- Periodicals; 616
• DOI: 10.1002/jmri.25965
• Languages: English
• ISSNs: 1053-1807

Abstract

Abstract : Background: Outcome prediction of asymmetrical prominent cortical veins (APCVs) on infarction is still debated and may help in selecting patients for reperfusion treatment. Purpose: To explore the relationship between fewer peripheral APCVs and the outcome in the patients of acute/subacute middle cerebral artery (MCA) infarctions as well as the relationship between this sign and stenosis of ipsilateral MCA. Study Type: Retrospective case–control study. Population: We enrolled 41 patients with MCA acute/subacute infarction. Compared to the low sign of cortical veins of contralateral hemisphere on susceptibility‐weighted imaging (SWI), these patients were divided into fewer ( n = 28) and prominent APCVs ( n = 13) groups. Field Strength/Sequence: 3.0T conventional stroke sequences, including T1 ‐weighted imaging, T2 ‐weighted imaging, fluid‐attenuated inversion recovery (FLAIR), diffusion‐weighted imaging (DWI) (b = 0 and 1000 s/mm 2 ), MR angiography (MRA), and SWI. Assessment: We explored the relationships between fewer peripheral APCVs sign and clinical outcome, as well as the relationship between this sign and the degree of ipsilateral MCA stenosis. Statistical Tests: Fisher's exact analysis, logistical regression, as well as Cohen's kappa coefficient were used for statistical analysis. Results: Fewer and prominent peripheral APCVs were detected in 28 (56.10%) and 13 (43.90%) patients. In 28 patients with fewer peripheral APCVs, 23 patients (82.14%) had a favorable outcome (modified Rankin Scale [mRS] ≤2), and five patients (17.76%) had an unfavorable outcome (mRS >2) ( P = 0.010). In terms of MCA stenosis, the rate of normal and mild to moderate stenosis of MCA in the fewer APCVs group (82.14%) was higher than that in the prominent APCVs group (23.08%) ( P < 0.001). More severe stenosis of ipsilateral MCA was found in patients with prominent APCVs group (76.92%) than that of fewer APCVs group (17.86%). The peripheral APCVs was positively correlated with the degree of MCA stenosis ( r = 0.538, P < 0.001). Data Conclusion: Fewer peripheral APCVs may suggest a favorable outcome in unilateral MCA infarction. The patency of ipsilateral MCA may correlate to fewer APCVs and favorable outcome. Level of Evidence: 3 Technical Efficacy: Stage 5 J. Magn. Reson. Imaging 2018;48:964–970.