The Value Of Flair Hyperintense Vessel Sign Of Middle Cerebral In The Diagnosis And Clinical Prognosis Of Patients With Acute Ischemic Infarction

Objective To investigate the value of magnetic resonance fluid attenuated inversion recovery(FLAIR)sequence hyperintense vessel sign(HVS)in evaluating the severity and prognosis of acute ischemic stroke patients.Methods A retrospective analysis of 52 patients with acute ischemic infarction in acute middle cerebral artery territory who had neurological impairment and underwent clinical MR in December 2016 June 2017.All patients underwent 3.0T GE cranial MR examination,including axial T1 WI,axial and sagittal T2 WI,diffusion-weighted imaging(DWI),axial T2 FLAIR and magnetic resonance angiography(MRA).According to the presence of hyperintense vessel sign,all cases were divided into hyperintense vessel sign group and non-hyperintense vessel sign group.Compare two groups in infarct size on DWI and the National Institutes of Health Stroke Scale(NIHSS)upon admission and after 10 days of treatment and basic clinical data,analyze the value of hyperintense vessel sign in the assessment of severity and prognosis in patients with acute ischemic infarction in the middle cerebral artery.Result There were 52 cases of acute ischemic cerebral infarction in middle cerebral artery territory,31 males and 21 females,aged 32-89 years,with an average age of 62.98±13.08 years,HVS is observed in 35 of 52 patients(67%),and 17 cases(33%)without HVS.The infarct volume of No distal HVS group and distal HVS group were 89.74±28.82 and 73.15 ±26.37,initial NIHSS scores were 16(6-27)and 10(2-21),the NIHSS scores at discharge were 13(6-26)and8(0-19),respectively.The distal HVS group and no distal HVS group significant difference(p<0.05).The stenosis degree of the brain artery is divided into 3 groups,mild stenosis,obvious stenosis and occlusion,the proportion of HVS positive group were 7/19(37%),11/15(73%),17/18(94%),HVS negative group were 12/19(63%),4/15(27%)and 1/18(6%),respectively.Conclusion HVS on T2 FLAIR sequence is an important imaging sign of middle cerebral artery territory acute ischemic infarction,which indicates severe stenosis or occlusion of intracranial large artery.The patients with distal HVS have smaller infarct size,lower NIHSS score and better clinical prognosis.The higher degree of middle cerebral arterial stenosis,the higher incidence of HVS.The reason of Middle cerebral artery region distal HVS of acute ischemic cerebral infarction may be the leptomeningeal collateral circulation in reverse blood flow after the brain artery stenosis or occlusion.The combination of middle cerebral artery HVS and MRA is helpful for clinical evaluation of the extent of cerebral infarction,the location of vascular lesions and the degree of stenosis,which can prompt the physician to take early clinical intervention and improve the prognosis of patients.