Sequential MR Assessment of the Susceptibility Vessel Sign and Arterial Occlusion in Acute Stroke

  • Thomas Ritzenthaler
  • Audrey Lacalm
  • Tae-Hee Cho
  • Delphine Maucort-Boulch
  • Irene Klaerke Mikkelsen
  • Lars Ribe
  • Leif Østergaard
  • Niels Hjort
  • Jens Fiehler
  • Salvador Pedraza
  • Guy Louis Tisserand
  • Jean-Claude Baron
  • Yves Berthezene
  • Norbert Nighoghossian


PURPOSE: Susceptibility vessel sign (SVS) may likely influence recanalization after thrombolysis. We assessed, through the European sequential MRI database "I-KNOW," the relationship between the presence of SVS on T2-weighted gradient echo imaging, its angiographic counterpart on magnetic resonance angiography and its subsequent impact on recanalization after thrombolysis.

MATERIALS AND METHODS: Initial clinical and MRI characteristics and early follow up were analyzed in acute ischemic stroke patients treated with rt-Pa within 4.5 hours. Patients underwent multimodal MRI at admission. Sequential imaging performed 3 hours, 2 days and 1 month later allowed the analysis of SVS changes and recanalization.

RESULTS: Fifty patients were included in the study. SVS was observed in 54% of cases at admission. SVS was still present in 46% patients at 3 hours, 16% at 2 days, and 0% at 1 month. It was an independent predictor of no recanalization after thrombolysis (P = .04). After 3 hours, SVS disappeared in only 4 cases, and was not linked with recanalization on MRA. Conversely, when SVS persisted, a partial or complete recanalization was observed in 9 and 6 cases, respectively.

CONCLUSIONS: SVS is a predictor of lower recanalization rate. Its disappearance is not necessarily correlated with recanalization.

Bibliografische Daten

StatusVeröffentlicht - 01.05.2016
PubMed 26552863