J Stroke.  2016 Jan;18(1):73-79. 10.5853/jos.2015.01417.

Susceptibility-Weighted Imaging for Detection of Thrombus in Acute Cardioembolic Stroke

• Park MG
• Oh SJ
• Baik SK
• Jung DS
• Park KP

• KMID: 2223638
• DOI: http://doi.org/10.5853/jos.2015.01417

Abstract

BACKGROUND AND PURPOSE
Susceptibility-weighted imaging (SWI) can show an intravascular thrombus as a hypointense susceptibility vessel sign (SVS). In this study, we investigated the usefulness of SWI in the detection of an intravascular thrombus in acute cardioembolic stroke by comparing the SVS on SWI to the vessel status on time-of-flight magnetic resonance angiography (MRA).
METHODS
We consecutively enrolled patients with cardioembolic stroke in the anterior circulation within 3 days from stroke onset. The frequency and location of the SVS on SWI were compared with those of occlusion on MRA.
RESULTS
One hundred and twenty-two patients were conclusively enrolled in this study. The SVS was observed in 75.4% (92/122) of the enrolled patients. MRA showed occlusion in 57% (70/122) of the enrolled patients. The SVS was identified in all 70 patients with occlusion on MRA. The SVS was observed in 22 (42.3%) of 52 patients without occlusion on MRA (P<0.001), which was identified mainly in post-bifurcation segments of the middle cerebral artery: the M2 segment in 4 patients, M3 segment in 10 patients, M4 segment in 4 patients, A3 segment in 1 patient, and multiple segments in 2 patients. The mean length of the SVS in the M1 segment was 13.65 mm (median: 12.39 mm, length range: 2.70-39.50 mm).
CONCLUSIONS
SWI can provide useful information about the thrombus location, the presence of a single thrombus or multiple thrombi especially in distal intracranial arteries, and the thrombus burden, all in acute cardioembolic stroke.

Keyword

Acute stroke; Diagnosis; Magnetic resonance imaging; Magnetic resonance angiography

MeSH Terms

Arteries
Diagnosis
Humans
Magnetic Resonance Angiography
Magnetic Resonance Imaging
Middle Cerebral Artery
Stroke*
Thrombosis*