The prominent hypointense vessel sign on susceptibility-weighted imaging (SWI) as a potential imaging biomarker for poor clinical outcome in acute ischemic stroke (AIS)

Susceptibility-weighted imaging (SWI) is a relatively new magnetic resonance imaging (MRI) technique used in the workup and diagnosis of brain pathologies. In the context of acute ischemic stroke (AIS), it is increasingly becoming useful in the diagnosis, treatment, and further management of these p...

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Main Authors: Abdul Rashid, Anna Misyail, Mohd Yaakob, Mohd Naim, Kamis, Mohd Fandi Al-Khafiz, Md Noh, Mohamad Syafeeq Faeez
Format: Article
Published: Elsevier 2022
Online Access:http://psasir.upm.edu.my/id/eprint/103681/
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author Abdul Rashid, Anna Misyail
Mohd Yaakob, Mohd Naim
Kamis, Mohd Fandi Al-Khafiz
Md Noh, Mohamad Syafeeq Faeez
author_facet Abdul Rashid, Anna Misyail
Mohd Yaakob, Mohd Naim
Kamis, Mohd Fandi Al-Khafiz
Md Noh, Mohamad Syafeeq Faeez
author_sort Abdul Rashid, Anna Misyail
building UPM Institutional Repository
collection Online Access
description Susceptibility-weighted imaging (SWI) is a relatively new magnetic resonance imaging (MRI) technique used in the workup and diagnosis of brain pathologies. In the context of acute ischemic stroke (AIS), it is increasingly becoming useful in the diagnosis, treatment, and further management of these patients. An elderly man with metabolic syndrome presented to us with an acute onset of right sided body weakness and aphasia. Urgent imaging via MRI noted a left middle cerebral artery (MCA) occlusion. Diffusion-weighted imaging (DWI)/fluid attenuated inversion recovery (FLAIR) mismatch was noted with an acute infarct involving the left MCA territory; hence, treatment with intravenous (IV) thrombolysis was administered. On SWI, the prominent hypointense vessel sign was noted. Recanalization of the occluded left MCA was seen on diagnostic cerebral angiography post IV thrombolysis, however, the patient was noted to have early neurological deterioration (END) and poor early stage clinical outcome, despite repeat MRI showing recanalization of the left MCA occlusion and reversal of the prominent hypointense vessel sign on SWI. Presence of the prominent hypointense vessel sign on SWI in AIS patients is associated with poor clinical outcome, unsuccessful recanalization rates, END, poor early stage clinical outcome, and infarct core progression. Some studies have shown an association between this imaging sign and poor collateral circulation status. Therefore, this imaging sign could potentially prove to be a useful imaging biomarker. However, more studies are needed to validate this theory.
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spelling upm-1036812023-05-05T03:08:49Z http://psasir.upm.edu.my/id/eprint/103681/ The prominent hypointense vessel sign on susceptibility-weighted imaging (SWI) as a potential imaging biomarker for poor clinical outcome in acute ischemic stroke (AIS) Abdul Rashid, Anna Misyail Mohd Yaakob, Mohd Naim Kamis, Mohd Fandi Al-Khafiz Md Noh, Mohamad Syafeeq Faeez Susceptibility-weighted imaging (SWI) is a relatively new magnetic resonance imaging (MRI) technique used in the workup and diagnosis of brain pathologies. In the context of acute ischemic stroke (AIS), it is increasingly becoming useful in the diagnosis, treatment, and further management of these patients. An elderly man with metabolic syndrome presented to us with an acute onset of right sided body weakness and aphasia. Urgent imaging via MRI noted a left middle cerebral artery (MCA) occlusion. Diffusion-weighted imaging (DWI)/fluid attenuated inversion recovery (FLAIR) mismatch was noted with an acute infarct involving the left MCA territory; hence, treatment with intravenous (IV) thrombolysis was administered. On SWI, the prominent hypointense vessel sign was noted. Recanalization of the occluded left MCA was seen on diagnostic cerebral angiography post IV thrombolysis, however, the patient was noted to have early neurological deterioration (END) and poor early stage clinical outcome, despite repeat MRI showing recanalization of the left MCA occlusion and reversal of the prominent hypointense vessel sign on SWI. Presence of the prominent hypointense vessel sign on SWI in AIS patients is associated with poor clinical outcome, unsuccessful recanalization rates, END, poor early stage clinical outcome, and infarct core progression. Some studies have shown an association between this imaging sign and poor collateral circulation status. Therefore, this imaging sign could potentially prove to be a useful imaging biomarker. However, more studies are needed to validate this theory. Elsevier 2022 Article PeerReviewed Abdul Rashid, Anna Misyail and Mohd Yaakob, Mohd Naim and Kamis, Mohd Fandi Al-Khafiz and Md Noh, Mohamad Syafeeq Faeez (2022) The prominent hypointense vessel sign on susceptibility-weighted imaging (SWI) as a potential imaging biomarker for poor clinical outcome in acute ischemic stroke (AIS). Radiology Case Reports, 17 (11). 4268 - 4271. ISSN 2090-6862; ESSN: 2090-6870 https://www.sciencedirect.com/science/article/pii/S193004332200677X?via%3Dihub 10.1016/j.radcr.2022.08.013
spellingShingle Abdul Rashid, Anna Misyail
Mohd Yaakob, Mohd Naim
Kamis, Mohd Fandi Al-Khafiz
Md Noh, Mohamad Syafeeq Faeez
The prominent hypointense vessel sign on susceptibility-weighted imaging (SWI) as a potential imaging biomarker for poor clinical outcome in acute ischemic stroke (AIS)
title The prominent hypointense vessel sign on susceptibility-weighted imaging (SWI) as a potential imaging biomarker for poor clinical outcome in acute ischemic stroke (AIS)
title_full The prominent hypointense vessel sign on susceptibility-weighted imaging (SWI) as a potential imaging biomarker for poor clinical outcome in acute ischemic stroke (AIS)
title_fullStr The prominent hypointense vessel sign on susceptibility-weighted imaging (SWI) as a potential imaging biomarker for poor clinical outcome in acute ischemic stroke (AIS)
title_full_unstemmed The prominent hypointense vessel sign on susceptibility-weighted imaging (SWI) as a potential imaging biomarker for poor clinical outcome in acute ischemic stroke (AIS)
title_short The prominent hypointense vessel sign on susceptibility-weighted imaging (SWI) as a potential imaging biomarker for poor clinical outcome in acute ischemic stroke (AIS)
title_sort prominent hypointense vessel sign on susceptibility-weighted imaging (swi) as a potential imaging biomarker for poor clinical outcome in acute ischemic stroke (ais)
url http://psasir.upm.edu.my/id/eprint/103681/
http://psasir.upm.edu.my/id/eprint/103681/
http://psasir.upm.edu.my/id/eprint/103681/