Abstract T P50: Vanishing of Hyperintense Vessels on FLAIR Predicts Good Outcome in Tissue Plasminogen Activator Patients
Background and Purpose: Hyperintense vessels (HV) on FLAIR detected in patients with acute ischemic stroke indicate cerebral hypoperfusion. Thus, vanishing of HV should indicate reperfusion. We investigated serial changes of HV in patients who received tissue plasminogen activator (t-PA) therapy, comparing changes with clinical outcomes.
Methods: We studied t-PA patients presenting with HV on FLAIR in the middle cerebral artery territory. Patients underwent brain MRI before and 1 hour after t-PA infusion. HV scores (range, 1–7) were evaluated according to ASPECTS territories. Patients were divided into two groups based on whether there was a decrease in HV scores (DHV). Multivariate logistic regression analysis was conducted to identify variables independently associated with good outcomes.
Results: A total of 118 patients were consecutively enrolled (73 men; mean age, 76±9.7 years; median initial HV score, 5), and 52 (44%) were classified as DHV. Patients in the DHV group had statistically significantly lower NIHSS time course (P<0.001) and smaller infarct volume time course (P<0.001) compared with those not in the DHV group. Multivariate analysis, adjusting for age, sex, glucose, atrial fibrillation, ICA occlusion, baseline NIHSS, time from stroke onset to treatment, and infarct volume on admission, showed that DHV was independently associated with good outcomes (OR 3.59, 95% CI, 1.58–9.97, P<0.01). The sensitivity and specificity of DHV for good outcome were 70% and 68%, respectively.
Conclusion: Vanishing of HV on FLAIR predicts good outcome in patients receiving t-PA therapy.
Author Disclosures: K. Sakuta: None. N. Saji: None. J. Aoki: None. K. Shibazaki: None. Y. Iguchi: None. K. Kimura: None.
- © 2015 by American Heart Association, Inc.