Fluid-attenuated inversion recovery vascular hyperintensities and acute ischemic stroke outcome

Objective: We investigated whether hyperintense vessels on fluid-attenuated inversion recovery (FLAIR) sequences are associated with stroke outcome. Method: Thirty-nine patients with acute ischemic stroke in the emergency green channel in Tiantan Hospital were enrolled including 25 male patients and 14 female patients with the mean age of 59.79 ± 12.99 years. All the patients underwent MR examination including DWI, MRA and FLAIR at baseline, 36 completed followup MR examination at 7 days after stroke onset, and 38 cases completed Modified Rankin Scale (mRS) evaluation at 90 days. According to the MRA appearance at 7 days, patients were divided into two groups: vascular recanalization group and non-vascular recanalization group. According to the mRS at 90 days, patients were divided into two groups: good outcome group and bad outcome group. We assessed the presence of FLAIR hyperintense vessels (FHV) at the baseline and disappearance of FHV at 7 days. The presence of FHV at the baseline between good and bad outcome groups, the disappearance of FHV between vascular recanalization and non-vascular recanalization groups were compared respectively using Fisher's exact test. Result: Among the 36 cases who completed 7-day MRI followup, 24 cases presented vascular recanalization. Seventeen of the 18 cases (70.83%) who presented FHV disappearance were in the vascular recanalization group, and 1 of 12 case (8.33%) was in non-vascular recanalization group, showing significant difference (P < 0.01). There were 38 cases underwent 90-days followup, 29 cases with good outcome and 9 cases with bad outcome. The number of slices showing FHV and modified Alberta Stroke Program Early CT Score (ASPECTS) of FHV at the baseline had no significant difference between good outcome group and bad outcome group (P > 0.05). Conclusion: The presence of FHV can not predict clinical outcome at 90 days. However, FHV disappearance in cases with vascular recanalization can be considered as a marker for hemodynamic improvement. (authors)