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The authors evaluated 244 consecutive patients eligible for reperfusion therapy with MCA stroke and pretreatment MR imaging with both FLAIR and PWI. The FLAIR vascular hyperintensity score was based on ASPECTS, ranging from 0 (no FLAIR vascular hyperintensity) to 7 (FLAIR vascular hyperintensities abutting all ASPECTS cortical areas). The hypoperfusion intensity ratio was defined as the ratio of the time-to-maximum >10-second over time-to-maximum >6-second lesion volumes. The FLAIR vascular hyperintensities were more extensive in patients with good collaterals than those with poor collaterals. The FLAIR vascular hyperintensity score was independently associated with good collaterals. They conclude that the ASPECTS assessment of FLAIR vascular hyperintensities could be used to rapidly identify patients more likely to benefit from reperfusion therapy.