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Research ArticleBRAIN

Diagnostic and Prognostic Value of Early MR Imaging Vessel Signs in Hyperacute Stroke Patients Imaged <3 Hours and Treated with Recombinant Tissue Plasminogen Activator

Peter D. Schellinger, Julio A. Chalela, Dong-Wha Kang, Lawrence L. Latour and Steven Warach
American Journal of Neuroradiology March 2005, 26 (3) 618-624;
Peter D. Schellinger
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Julio A. Chalela
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Dong-Wha Kang
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Lawrence L. Latour
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Steven Warach
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    Fig 1.

    An 82-year-old female patient with cardioembolic stroke, baseline NIHSSS of 18 received rt-PA 88 minutes after symptom onset. Stroke MR imaging at 40 minutes after symptom onset. MRA (upper left) shows left-sided ICA occlusion extending into the MCA (arrows). This occlusion is seen on GRE (upper right, arrows) as a GRE SVS only at the level of the MCA, a FLAIR HVS can be seen at the level of the ICA and MCA (lower row, arrows).

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    TABLE 1:

    Early vessel signs at baseline

    PWI/MRA: Vessel Occlusion, BaselineCT baseline HMCASFLAIR baseline HVSGRE baseline SVS
    NoYesTotalNoYesTotalNoYesTotal
    No60693129312
    Yes151025152944291544
        Total211031243256381856
    Sensitivity (%)4065.934.1
    Specificity (%)1007575
    PPV (%)10090.683.3
    NPV (%)28.637.523.7
    Accuracy (%)51.667.942.9
    • View popup
    TABLE 2:

    Early vessel signs at 2 hours

    PWI/MRA: Vessel Occlusion, 2 HoursFLAIR 2-Hour HVSGRE 2-Hour SVS
    NoYesTotalNoYesTotal
    No2002014620
    Yes112536181836
        Total312556322456
    Sensitivity (%)69.450
    Specificity (%)10070
    PPV (%)10075
    NPV (%)64.543.8
    Accuracy (%)80.457.1
    • View popup
    TABLE 3:

    Early vessel signs at 24 hours

    PWI/MRA: Vessel Occlusion, 24 HoursFLAIR 24-Hour HVSGRE 24-Hour SVS
    NoYesTotalNoYesTotal
    No2913026430
    Yes131326121426
        Total421456381856
    Sensitivity (%)5053.8
    Specificity (%)96.786.7
    PPV (%)92.977.8
    NPV (%)6968.4
    Accuracy (%)7571.4
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American Journal of Neuroradiology: 26 (3)
American Journal of Neuroradiology
Vol. 26, Issue 3
1 Mar 2005
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Diagnostic and Prognostic Value of Early MR Imaging Vessel Signs in Hyperacute Stroke Patients Imaged <3 Hours and Treated with Recombinant Tissue Plasminogen Activator
Peter D. Schellinger, Julio A. Chalela, Dong-Wha Kang, Lawrence L. Latour, Steven Warach
American Journal of Neuroradiology Mar 2005, 26 (3) 618-624;

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Diagnostic and Prognostic Value of Early MR Imaging Vessel Signs in Hyperacute Stroke Patients Imaged <3 Hours and Treated with Recombinant Tissue Plasminogen Activator
Peter D. Schellinger, Julio A. Chalela, Dong-Wha Kang, Lawrence L. Latour, Steven Warach
American Journal of Neuroradiology Mar 2005, 26 (3) 618-624;
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  • M1 Susceptibility Vessel Sign on T2* as a Strong Predictor for No Early Recanalization After IV-t-PA in Acute Ischemic Stroke
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  • Recanalization after thrombolysis in stroke patients: Predictors and prognostic implications
  • Temporal Profile of Recanalization After Intravenous Tissue Plasminogen Activator: Selecting Patients for Rescue Reperfusion Techniques
  • Significance of Susceptibility Vessel Sign on T2*-Weighted Gradient Echo Imaging for Identification of Stroke Subtypes
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