Association of Posttreatment Hyperperfusion on Arterial Spin Labeling with Fluid-Attenuated Inversion Recovery Vascular Hyperintensity in Patients with Acute Ischemic Stroke after Endovascular Therapy.

IF 2.1 Q3 PERIPHERAL VASCULAR DISEASE

Cerebrovascular Diseases Extra Pub Date : 2026-01-01 Epub Date: 2026-01-09 DOI:10.1159/000550385

Wen-Jing Ni, Guang-Chen Shen, Gao Ma, Yue Chu, Zi-Xin Yin, Shan-Shan Lu, Hai-Bin Shi, Fei-Yun Wu, Xiao-Quan Xu

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引用次数: 0

Abstract

Introduction: The prognosis of patients with acute ischemic stroke (AIS) following endovascular therapy (EVT) is largely influenced by the extent of reperfusion. Fluid-attenuated inversion recovery vascular hyperintensity (FVH) is a simple imaging sign which assessed based on fluid-attenuated inversion recovery (FLAIR) images. We aimed to evaluate whether FVH on posttreatment FLAIR can serve as a surrogate imaging marker of cortical hyperperfusion identified by arterial spin labeling (ASL) in patients with AIS after EVT.

Methods: We retrospectively enrolled 150 patients with AIS who achieved successful recanalization after EVT. Clinical data and posttreatment magnetic resonance imaging sequences including diffusion-weighted imaging (DWI), FLAIR, and ASL were systematically collected. The 150 patients were categorized into four groups based on DWI and FVH status (A: DWI-, FVH-; B: DWI+, FVH-; C: DWI-, FVH+; D: DWI+, FVH+). Perfusion was evaluated within six predefined Alberta Stroke Program Early CT Score (ASPECTS) regions (M1-M6) per patient, yielding a total of 900 cortical regions analyzed. The perfusion status was evaluated based on visual assessment of absolute cerebral blood flow maps derived from ASL, followed by statistical analysis.

Results: Among the 900 cortical territories, 250 (27.78%) were classified as group A, 361 (40.11%) as group B, 55 (6.11%) as group C, and 234 (26.00%) as group D. Inter-rater agreement for evaluating the status of posttreatment FVH was excellent (κ = 0.851). There were significant differences in perfusion characteristics across four groups (p < 0.001). In subgroup analysis, group C exhibited a higher proportion of hyperperfusion compared to group A (21.82% vs. 15.20%), although the difference did not reach significance (p = 0.442), while group D demonstrated a significantly higher percentage of hyperperfusion relative to group B (48.72% vs. 34.34%, p < 0.001).

Conclusion: Positive FVH may be associated with post-EVT cortical hyperperfusion in AIS patients following successful revascularization.

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急性缺血性卒中患者血管内治疗后动脉自旋标记治疗后高灌注与液体衰减反转恢复血管高强度的关系

目的：评价急性缺血性卒中（AIS）患者血管内治疗（EVT）后，液体衰减反转恢复血管高强度（FVH）能否作为动脉自旋标记（ASL）识别皮质高灌注的替代成像标志物。材料和方法：我们回顾性地招募了150例在EVT后成功再通的AIS患者。系统收集临床资料和治疗后磁共振成像（MRI）序列，包括弥散加权成像（DWI）、FLAIR和ASL。根据DWI和FVH状态将150例患者分为4组（A: DWI-、FVH-; B: DWI+、FVH-; C: DWI-、FVH+; D: DWI+、FVH+）。灌注在每个患者预定义的六个阿尔伯塔卒中计划早期CT评分（ASPECTS）区域（M1-M6）中进行评估，共分析了900个皮质区域。根据ASL获得的绝对脑血流量（CBF）图视觉评估灌注状态，然后进行统计分析。结果：900个皮质区域中，A组250个（27.78%），B组361个（40.11%），C组55个（6.11%），d组234个（26.00%），治疗后FVH状态的评分一致性极好（κ = 0.851）。四组间灌注特征差异有统计学意义（p < 0.001）。在亚组分析中，C组高灌注比例高于a组（21.82%比15.20%），但差异无统计学意义（p = 0.442），而D组高灌注比例高于B组（48.72%比34.34%,p < 0.001）。结论：AIS患者血运重建成功后，FVH阳性可能与evt后皮层高灌注有关。

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来源期刊

Cerebrovascular Diseases Extra PERIPHERAL VASCULAR DISEASE-

CiteScore

3.50

自引率

0.00%

发文量

审稿时长

8 weeks

期刊介绍： This open access and online-only journal publishes original articles covering the entire spectrum of stroke and cerebrovascular research, drawing from a variety of specialties such as neurology, internal medicine, surgery, radiology, epidemiology, cardiology, hematology, psychology and rehabilitation. Offering an international forum, it meets the growing need for sophisticated, up-to-date scientific information on clinical data, diagnostic testing, and therapeutic issues. The journal publishes original contributions, reviews of selected topics as well as clinical investigative studies. All aspects related to clinical advances are considered, while purely experimental work appears only if directly relevant to clinical issues. Cerebrovascular Diseases Extra provides additional contents based on reviewed and accepted submissions to the main journal Cerebrovascular Diseases.