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The Hypodense Artery Sign

Thomas C. Leea, Eric S. Bartletta, Allan J. Foxa and Sean P. Symonsa

a Division of Neuroradiology, Department of Medical Imaging, Sunnybrook and Women’s College Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada



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  		FIG 1. A 78-year-old woman who had undergone a mitral valve replacement.

A–C, Axial images from the initial CT head scan obtained on the first postoperative day demonstrate an early left middle cerebral artery territory infarct. There is a fat attenuation filling defect (arrow, B) in the region of the proximal left middle cerebral artery trunk.



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  		FIG 2. CT angiography axial image obtained 13 days postoperatively confirms that the fat attenuation lesion (arrow) is within the proximal left middle cerebral artery trunk.



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  		FIG 3. Axial and coronal T1-weighted MR images obtained 49 days postoperatively without fat saturation (A,B) and with fat saturation (C,D). The images without fat saturation demonstrate the T1-hyperintense embolus (arrow) in the proximal left M1 trunk. After fat saturation, the T1 hyperintensity of the embolus is saturated (arrow), confirming its fatty composition. High-signal-intensity methemoglobin in the adjacent infarct is unchanged before and after fat saturation.





Copyright © 2009 by the American Society of Neuroradiology. Print ISSN: 0195-6108 Online ISSN: 1936-959X