Korean Journal of Radiology

  • 제16권4호
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  • Pages.906-913
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  • 2015
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  • 1229-6929(pISSN)
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  • 2005-8330(eISSN)
대한영상의학회 (The Korean Society of Radiology)
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Clinical Implications of Sulcal Enhancement on Postcontrast Fluid Attenuated Inversion Recovery Images in Patients with Acute Stroke Symptoms

  • Lee, Hyukjoon (Department of Radiology, Seoul National University College of Medicine, Seoul National University Bundang Hospital) ;
  • Kim, Eunhee (Department of Radiology, Seoul National University College of Medicine, Seoul National University Bundang Hospital) ;
  • Lee, Kyung Mi (Department of Radiology, Seoul National University College of Medicine, Seoul National University Bundang Hospital) ;
  • Kim, Jae Hyoung (Department of Radiology, Seoul National University College of Medicine, Seoul National University Bundang Hospital) ;
  • Bae, Yun Jung (Department of Radiology, Seoul National University College of Medicine, Seoul National University Bundang Hospital) ;
  • Choi, Byoung Se (Department of Radiology, Seoul National University College of Medicine, Seoul National University Bundang Hospital) ;
  • Jung, Cheolkyu (Department of Radiology, Seoul National University College of Medicine, Seoul National University Bundang Hospital)
  • 투고 : 2014.11.03
  • 심사 : 2015.04.13
  • 발행 : 2015.08.01
⟨ 이전 논문 다음 논문 ⟩

초록

Objective: Hyperintense acute reperfusion marker (HARM) without diffusion abnormalities is occasionally found in patients with an acute stroke. This study was to determine the prevalence and clinical implications of HARM without diffusion abnormalities. Materials and Methods: There was a retrospective review of magnetic resonance images 578 patients with acute strokes and identified those who did not have acute infarction lesions, as mapped by diffusion-weighted imaging (DWI). These patients were classified into an imaging-negative stroke and HARM without diffusion abnormalities groups, based on the DWI findings and postcontrast fluid attenuated inversion recovery images. The National Institutes of Health Stroke Scale (NIHSS) scores at admission, 1 day, and 7 days after the event, as well as clinical data and risk factors, were compared between the imaging-negative stroke and HARM without diffusion abnormalities groups. Results: Seventy-seven acute stroke patients without any DWI abnormalities were found. There were 63 patients with an imaging-negative stroke (accounting for 10.9% of 578) and 13 patients with HARM without diffusion abnormalities (accounting for 2.4% of 578). The NIHSS scores at admission were higher in HARM without diffusion abnormalities group than in the imaging-negative stroke group (median, 4.5 vs. 1.0; p < 0.001), but the scores at 7 days after the event were not significantly different between the two groups (median, 0 vs. 0; p = 1). The patients with HARM without diffusion abnormalities were significantly older, compared with patients with an imaging-negative stroke (mean, 73.1 years vs. 55.9 years; p < 0.001). Conclusion: Patients with HARM without diffusion abnormalities are older and have similarly favorable short-term neurological outcomes, compared with the patients with imaging-negative stroke.

키워드

참고문헌

  1. Kohrmann M, Struffert T, Frenzel T, Schwab S, Doerfler A. The hyperintense acute reperfusion marker on fluid-attenuated inversion recovery magnetic resonance imaging is caused by gadolinium in the cerebrospinal fluid. Stroke 2012;43:259-261 https://doi.org/10.1161/STROKEAHA.111.632356
  2. Bonzano L, Roccatagliata L, Levrero F, Mancardi GL, Sardanelli F. In vitro investigation of poor cerebrospinal fluid suppression on fluid-attenuated inversion recovery images in the presence of a gadolinium-based contrast agent. Magn Reson Med 2008;60:220-223 https://doi.org/10.1002/mrm.21619
  3. Ewing JR, Knight RA, Nagaraja TN, Yee JS, Nagesh V, Whitton PA, et al. Patlak plots of Gd-DTPA MRI data yield blood-brain transfer constants concordant with those of 14C-sucrose in areas of blood-brain opening. Magn Reson Med 2003;50:283-292 https://doi.org/10.1002/mrm.10524
  4. Warach S, Latour LL. Evidence of reperfusion injury, exacerbated by thrombolytic therapy, in human focal brain ischemia using a novel imaging marker of early blood-brain barrier disruption. Stroke 2004;35(11 Suppl 1):2659-2661 https://doi.org/10.1161/01.STR.0000144051.32131.09
  5. Dechambre SD, Duprez T, Grandin CB, Lecouvet FE, Peeters A, Cosnard G. High signal in cerebrospinal fluid mimicking subarachnoid haemorrhage on FLAIR following acute stroke and intravenous contrast medium. Neuroradiology 2000;42:608-611 https://doi.org/10.1007/s002340000347
  6. Latour LL, Kang DW, Ezzeddine MA, Chalela JA, Warach S. Early blood-brain barrier disruption in human focal brain ischemia. Ann Neurol 2004;56:468-477 https://doi.org/10.1002/ana.20199
  7. Henning EC, Latour LL, Warach S. Verification of enhancement of the CSF space, not parenchyma, in acute stroke patients with early blood-brain barrier disruption. J Cereb Blood Flow Metab 2008;28:882-886 https://doi.org/10.1038/sj.jcbfm.9600598
  8. Rozanski M, Ebinger M, Schmidt WU, Hotter B, Pittl S, Heuschmann PU, et al. Hyperintense acute reperfusion marker on FLAIR is not associated with early haemorrhagic transformation in the elderly. Eur Radiol 2010;20:2990-2996 https://doi.org/10.1007/s00330-010-1881-9
  9. Ogami R, Nakahara T, Hamasaki O, Araki H, Kurisu K. Cerebrospinal fluid enhancement on fluid attenuated inversion recovery images after carotid artery stenting with neuroprotective balloon occlusions: hemodynamic instability and blood-brain barrier disruption. Cardiovasc Intervent Radiol 2011;34:936-941 https://doi.org/10.1007/s00270-010-0035-4
  10. Barr TL, Latour LL, Lee KY, Schaewe TJ, Luby M, Chang GS, et al. Blood-brain barrier disruption in humans is independently associated with increased matrix metalloproteinase-9. Stroke 2010;41:e123-e128 https://doi.org/10.1161/STROKEAHA.109.570515
  11. Merino JG, Latour LL, Tso A, Lee KY, Kang DW, Davis LA, et al. Blood-brain barrier disruption after cardiac surgery. AJNR Am J Neuroradiol 2013;34:518-523 https://doi.org/10.3174/ajnr.A3251
  12. Kim DW, Moon Y, Gee Noh H, Choi JW, Oh J. Blood-brain barrier disruption is involved in seizure and hemianopsia in nonketotic hyperglycemia. Neurologist 2011;17:164-166 https://doi.org/10.1097/NRL.0b013e3182173528
  13. Kidwell CS, Latour L, Saver JL, Alger JR, Starkman S, Duckwiler G, et al. Thrombolytic toxicity: blood brain barrier disruption in human ischemic stroke. Cerebrovasc Dis 2008;25:338-343 https://doi.org/10.1159/000118379
  14. Farrall AJ, Wardlaw JM. Blood-brain barrier: ageing and microvascular disease--systematic review and meta-analysis. Neurobiol Aging 2009;30:337-352 https://doi.org/10.1016/j.neurobiolaging.2007.07.015

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  7. The Clinical Significance of the Hyperintense Acute Reperfusion Marker Sign in Subacute Infarction Patients vol.11, pp.11, 2015, https://doi.org/10.3390/diagnostics11112161