Value of susceptibility weighted imaging (SWI) in assessment of intra-arterial thrombus in patients with acute ischemic stroke
Abstract Background Ischemic stroke is a major cause of death and disability. Thrombolytic therapy is a standard treatment stroke nowadays for ischemic strokes up to 4.5 h from start of symptoms. Although arterial occlusion can be detected by digital subtraction angiography (DSA), magnetic resonance...
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| Format: | Article |
| Language: | English |
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SpringerOpen
2021-11-01
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| Series: | The Egyptian Journal of Radiology and Nuclear Medicine |
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| Online Access: | https://doi.org/10.1186/s43055-021-00649-0 |
| _version_ | 1819006552003051520 |
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| author | Ehab Ali Abdelgawad Mohammed F. Amin Ahmed Abdellatif Mohamed Aboulfotoh Mourad Manal F. Abusamra |
| author_facet | Ehab Ali Abdelgawad Mohammed F. Amin Ahmed Abdellatif Mohamed Aboulfotoh Mourad Manal F. Abusamra |
| author_sort | Ehab Ali Abdelgawad |
| collection | DOAJ |
| description | Abstract Background Ischemic stroke is a major cause of death and disability. Thrombolytic therapy is a standard treatment stroke nowadays for ischemic strokes up to 4.5 h from start of symptoms. Although arterial occlusion can be detected by digital subtraction angiography (DSA), magnetic resonance angiography (MRA), and computed tomography angiography (CTA), the question about thrombus composition and formation times still might not be replied. The use of susceptibility weighted imaging (SWI) for detecting thrombus in acute ischemic stroke is getting to be a strongly investigated field. SWI can show the thrombus as a hypointense susceptibility vessel sign (SVS) in the affected area. Results Ninety-seven of our patients showed thrombus in MRA study. M1 segment was the most affected MCA segment representing about 57.6%. SWI detected intra-arterial thrombus in 122 patients compared to 97 patients detected by MRA (P = 0.0002). All patients had positive susceptibility sign. 88.8% of patients with positive thrombus in SWI had solitary thrombus, and 11.2% has multiple thrombi; on the other hand, MRA fails to detect any distant thrombi. 81% of patients with abnormally prominent vessel sign (APVS) showed parenchymal changes in these areas. On the other hand, deep structures, namely caudate nucleus, internal capsule and lentiform nucleus, are the least affected areas. All patients with abnormally prominent vessel sign showed arterial occlusion, and only 9 patients with no APVS showed arterial occlusion (P = 0.0001). Conclusion SWI plays an important role in the detection of peripheral thrombi in patients with acute ischemic stroke. Both SWI and MRA might complement each other for visual detection of occluded vessel. We recommend implementation of SWI into routine acute stroke MRI protocols. |
| first_indexed | 2024-12-21T00:10:30Z |
| format | Article |
| id | doaj.art-4cda071e238b4dada29df3fc086d3f15 |
| institution | Directory Open Access Journal |
| issn | 2090-4762 |
| language | English |
| last_indexed | 2024-12-21T00:10:30Z |
| publishDate | 2021-11-01 |
| publisher | SpringerOpen |
| record_format | Article |
| series | The Egyptian Journal of Radiology and Nuclear Medicine |
| spelling | doaj.art-4cda071e238b4dada29df3fc086d3f152022-12-21T19:22:20ZengSpringerOpenThe Egyptian Journal of Radiology and Nuclear Medicine2090-47622021-11-015211810.1186/s43055-021-00649-0Value of susceptibility weighted imaging (SWI) in assessment of intra-arterial thrombus in patients with acute ischemic strokeEhab Ali Abdelgawad0Mohammed F. Amin1Ahmed Abdellatif2Mohamed Aboulfotoh Mourad3Manal F. Abusamra4Department of Radiology, Faculty of Medicine, Minia UniversityDepartment of Radiology, Faculty of Medicine, Minia UniversityDepartment of Radiology, Faculty of Medicine, Minia UniversityDepartment of Radiology, Faculty of Medicine, Minia UniversityDepartment of Radiology, Faculty of Medicine, Minia UniversityAbstract Background Ischemic stroke is a major cause of death and disability. Thrombolytic therapy is a standard treatment stroke nowadays for ischemic strokes up to 4.5 h from start of symptoms. Although arterial occlusion can be detected by digital subtraction angiography (DSA), magnetic resonance angiography (MRA), and computed tomography angiography (CTA), the question about thrombus composition and formation times still might not be replied. The use of susceptibility weighted imaging (SWI) for detecting thrombus in acute ischemic stroke is getting to be a strongly investigated field. SWI can show the thrombus as a hypointense susceptibility vessel sign (SVS) in the affected area. Results Ninety-seven of our patients showed thrombus in MRA study. M1 segment was the most affected MCA segment representing about 57.6%. SWI detected intra-arterial thrombus in 122 patients compared to 97 patients detected by MRA (P = 0.0002). All patients had positive susceptibility sign. 88.8% of patients with positive thrombus in SWI had solitary thrombus, and 11.2% has multiple thrombi; on the other hand, MRA fails to detect any distant thrombi. 81% of patients with abnormally prominent vessel sign (APVS) showed parenchymal changes in these areas. On the other hand, deep structures, namely caudate nucleus, internal capsule and lentiform nucleus, are the least affected areas. All patients with abnormally prominent vessel sign showed arterial occlusion, and only 9 patients with no APVS showed arterial occlusion (P = 0.0001). Conclusion SWI plays an important role in the detection of peripheral thrombi in patients with acute ischemic stroke. Both SWI and MRA might complement each other for visual detection of occluded vessel. We recommend implementation of SWI into routine acute stroke MRI protocols.https://doi.org/10.1186/s43055-021-00649-0MRISWIMRA |
| spellingShingle | Ehab Ali Abdelgawad Mohammed F. Amin Ahmed Abdellatif Mohamed Aboulfotoh Mourad Manal F. Abusamra Value of susceptibility weighted imaging (SWI) in assessment of intra-arterial thrombus in patients with acute ischemic stroke The Egyptian Journal of Radiology and Nuclear Medicine MRI SWI MRA |
| title | Value of susceptibility weighted imaging (SWI) in assessment of intra-arterial thrombus in patients with acute ischemic stroke |
| title_full | Value of susceptibility weighted imaging (SWI) in assessment of intra-arterial thrombus in patients with acute ischemic stroke |
| title_fullStr | Value of susceptibility weighted imaging (SWI) in assessment of intra-arterial thrombus in patients with acute ischemic stroke |
| title_full_unstemmed | Value of susceptibility weighted imaging (SWI) in assessment of intra-arterial thrombus in patients with acute ischemic stroke |
| title_short | Value of susceptibility weighted imaging (SWI) in assessment of intra-arterial thrombus in patients with acute ischemic stroke |
| title_sort | value of susceptibility weighted imaging swi in assessment of intra arterial thrombus in patients with acute ischemic stroke |
| topic | MRI SWI MRA |
| url | https://doi.org/10.1186/s43055-021-00649-0 |
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