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Arterial hyperintensity on BLADE fluid-attenuated inversion recovery images (FLAIR) in hyperacute territorial infarction: comparison with conventional FLAIR

  • Magnetic Resonance
  • Published:
European Radiology Aims and scope Submit manuscript

Abstract

Objectives

To evaluate the utility of BLADE fluid-attenuated inversion recovery images (FLAIR) magnetic resonance (MR) imaging compared to conventional FLAIR for the detection of arterial hyperintensity (AH) in hyperacute territorial infarction.

Methods

We retrospectively analysed MR images of patients with hyperacute (<6 h) territorial infarction over a 9-month study period. Special attention was paid to the presence or absence of AH in the frontal, parietal and temporal lobes and the number of AHs in the sylvian fissure. We also evaluated the presence of three kinds of artefacts on BLADE FLAIR and conventional FLAIR images.

Results

AH was seen in 41 (91 %) patients with conventional FLAIR and 45 (100 %) patients with BLADE FLAIR images. More instances of AH were detected in the frontal, parietal and temporal lobes and within the sylvian fissure using BLADE FLAIR. Motion artefacts, pulsation artefacts from the sigmoid sinus and incomplete cerebrospinal fluid (CSF) nulling that reduced image quality were observed more frequently on conventional FLAIR images than on BLADE FLAIR images.

Conclusions

BLADE FLAIR sequences are more sensitive than conventional FLAIR for the detection of AH in hyperacute territorial infarctions and provide better image quality by reducing artefacts. They may be used in place of conventional FLAIR for patients with hyperacute stroke.

Key points

• Arterial hyperintensity is an important sign in patients with acute territorial infarctions.

• BLADE FLAIR sequences are sensitive for the detection of AH.

• BLADE FLAIR sequences provide better image quality by reducing artefacts.

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Abbreviations

ADC:

apparent diffusion coefficient

AH:

arterial hyperintensity

BW:

bandwidth

CSF:

cerebrospinal fluid

DSA:

digital subtraction angiography

DWI:

diffusion-weighted image

ETL:

echo-training length

FOV:

field of view

FLAIR:

fluid-attenuated inversion recovery

ICA:

internal carotid artery

MCA:

middle cerebral artery

MRI:

magnetic resonance imaging

PACS:

picture-archiving and communication system

PROPELLER:

periodically rotated overlapping parallel lines with enhanced reconstruction

TE:

echo time

TOF:

time-of-flight

TR:

repetition time

TSE:

turbo spin-echo

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Acknowledgements

The scientific guarantor of this publication is Soo Mee Lim, M.D., Department of Radiology, Mokdong Hospital, Ewha Womans University School of Medicine. The authors of this manuscript declare no relationships with any companies whose products or services may be related to the subject matter of the article. This study has received funding by the Basic Science Research Program through the National Research Foundation of Korea (NRF) funded by the Ministry of Education Science and Technology (2012R1A2A2A01013169) and Ewha Womans University Global Top 5 Project Research Grant of 2012. No complex statistical methods were necessary for this paper. Institutional review board approval and written informed consent were not required because this study is a retrospective analysis of brain MRI, obtained for clinical purposes. Methodology: retrospective, observational study, performed at one institution.

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Authors and Affiliations

  1. Department of Radiology, Mokdong Hospital, Ewha Womans University School of Medicine, Seoul, 158-710, Korea

    Eujean Kwag, Soo Mee Lim, Ji Eun Park & In Hye Chae

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  1. Eujean Kwag
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Correspondence to Soo Mee Lim.

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Kwag, E., Lim, S.M., Park, J.E. et al. Arterial hyperintensity on BLADE fluid-attenuated inversion recovery images (FLAIR) in hyperacute territorial infarction: comparison with conventional FLAIR. Eur Radiol 24, 2045–2051 (2014). https://doi.org/10.1007/s00330-014-3210-1

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  • DOI: https://doi.org/10.1007/s00330-014-3210-1

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