Akut İskemik İnmede Manyetik Duyarlılık Ağırlıklı Görüntüleme (Susceptibility Weighted İmaging, Swı) Bulgularının, Diğer Klinik ve Görüntüleme Bulgularıyla İlişkisinin İncelenmesi

Abstract

Certain neuroimaging signs detected in SWI and FLAIR sequences are considered to provide information about tissue perfusion and therefore can be useful in making projections regarding clinical/radiological prognosis in acute ischemic stroke. This information is especially critical for many centers in which perfusion imaging cannot be performed routinely. In this study, we aimed to investigate the prevalence of these neuroimaging signs observed on FLAIR and SWI, such as prominent cortical veins (PCV), brush sign and distal FLAIR hyperintense vessel (FHV) sign, assess their correlation with each other and determine the relationship of these signs with clinical and radiological prognosis. We therefore retrospectively analyzed a consecutive series of ischemic stroke patients with proximal MCA occlusion who underwent MR imaging within 24 hours after symptom onset. Among 50 patients who fulfilled the inclusion criteria, PCV, brush sign and FHV sign was positive in 74%, 40% and 92% of patients, respectively. PCV and FHV number were moderately, significantly correlated (r=0.421, p<0.01). In multivariate analysis PCV sign remained significantly associated with high discharge NIHSS (p=0.03) and mRS (p=0.02) scores and also with infarct growth (p=0.02). In bivariate analysis prominent deep medullary veins and associated brush sign was also associated significantly with prognostic scales and follow-up infarct volume, but this association did not persist in multivariate analysis. Prominent distal FHV was not associated with clinical or radiological prognosis. Our findings highlight the prognostic importance of SWI in ischemic stroke.