AIM:To review the literature on the assessment of venous vessels to estimate the penumbra on T2*w imaging and susceptibility-weighted imaging (SWI). METHODS:Literature that reported on the assessment of penumbra by T2...AIM:To review the literature on the assessment of venous vessels to estimate the penumbra on T2*w imaging and susceptibility-weighted imaging (SWI). METHODS:Literature that reported on the assessment of penumbra by T2*w imaging or SWI and used a validation method was included. PubMed and relevant stroke and magnetic resonance imaging (MRI) related conference abstracts were searched. Abstracts that had overlapping content with full text articles were excluded. The retrieved literature was scanned for further relevant references. Only clinical literature published in English was considered, patients with Moya-Moya syndrome were disregarded. Data is given as cumulative absolute and relative values, ranges are given where appropriate. RESULTS:Forty-three publications including 1145 patients could be identified. T2*w imaging was used in 16 publications (627 patients), SWI in 26 publications (453 patients). Only one publication used both (65 patients). The cumulative presence of hypointense vessel sign was 54% (range 32%-100%) for T2* (668 patients) and 81% (range 34%-100%) for SWI (334 patients). There was rare mentioning of interrater agreement (6 publications, 210 patients) and reliability (1 publication, 20 patients) but the numbers reported ranged from good to excellent. In most publications (n = 22) perfusion MRI was used as a validation method (617 patients). More patients were scanned in the subacute than in the acute phase (596 patients vs 320 patients). Clinical outcome was reported in 13 publications (521 patients) but was not consistent. CONCLUSION:The low presence of vessels signs on T2*w imaging makes SWI much more promising. More research is needed to obtain formal validation and quantification.展开更多
文摘AIM:To review the literature on the assessment of venous vessels to estimate the penumbra on T2*w imaging and susceptibility-weighted imaging (SWI). METHODS:Literature that reported on the assessment of penumbra by T2*w imaging or SWI and used a validation method was included. PubMed and relevant stroke and magnetic resonance imaging (MRI) related conference abstracts were searched. Abstracts that had overlapping content with full text articles were excluded. The retrieved literature was scanned for further relevant references. Only clinical literature published in English was considered, patients with Moya-Moya syndrome were disregarded. Data is given as cumulative absolute and relative values, ranges are given where appropriate. RESULTS:Forty-three publications including 1145 patients could be identified. T2*w imaging was used in 16 publications (627 patients), SWI in 26 publications (453 patients). Only one publication used both (65 patients). The cumulative presence of hypointense vessel sign was 54% (range 32%-100%) for T2* (668 patients) and 81% (range 34%-100%) for SWI (334 patients). There was rare mentioning of interrater agreement (6 publications, 210 patients) and reliability (1 publication, 20 patients) but the numbers reported ranged from good to excellent. In most publications (n = 22) perfusion MRI was used as a validation method (617 patients). More patients were scanned in the subacute than in the acute phase (596 patients vs 320 patients). Clinical outcome was reported in 13 publications (521 patients) but was not consistent. CONCLUSION:The low presence of vessels signs on T2*w imaging makes SWI much more promising. More research is needed to obtain formal validation and quantification.
文摘目的探究SWI不对称皮层静脉征(asymmetrical cortical vein sign,ACVS)的相关因素及其对急性缺血性卒中预后的预测价值。方法连续收集2016年11月-2017年11月在河北医科大学第三医院住院的急性大脑中动脉(middle cerebral artery,MCA)供血区梗死的患者125例。所有患者均在发病后7d内完成头颅MRI检查中的DWI、SWI及时间飞跃法(time of flight,TOF)MRA序列,并对ACVS、MCA狭窄程度和脑梗死范围进行评价。采用NIHSS评分评价患者基线神经功能受损情况,采用mRS评分对患者发病3个月时预后进行评估。将患者分为ACVS组和皮层静脉显影对称组。比较两组人口学信息、临床和影像信息,并通过Logistic回归分析评估ACVS对卒中预后的预测价值。结果在入组的125例患者中,95例(76.0%)SWI表现为显影程度对称的皮层静脉,30例(24.0%)SWI可见ACVS。与皮层静脉显影对称组相比,ACVS组患者MCA重度狭窄或闭塞更为常见(76.7%vs45.3%,P=0.003),Alberta卒中项目早期CT评分(Albert stroke program early CT score,ASPECTS)较低(7.5分vs8.0分,P=0.018),入院NIHSS评分较高(4.5分vs4.0分,P=0.042);两组患者的3个月不良预后情况(mRS评分>1分)差异无统计学意义(63.3%vs44.2%,P=0.093)。调整干扰因素后,Logistic回归显示ACVS不是患者3个月预后不良的独立预测因素。结论ACVS的存在与卒中患者MCA的狭窄程度、DWI病灶大小及入院时神经功能受损严重程度有关,但不能独立预测患者的3个月预后。
