title: Comparison of increased venous contrast in ischemic stroke using phase-sensitive MR imaging with perfusion changes on flow-sensitive alternating inversion recovery at 3 Tesla.
abstract: BACKGROUND
  Increased venous contrast in ischemic stroke using susceptibility-weighted imaging has been widely reported, although few reports have compared increased venous contrast areas with perfusion change areas.
  
  
  OBJECTIVE
  To compare venous contrast on phase-sensitive MR images (PSI) with perfusion change on flow-sensitive alternating inversion recovery (FAIR) images, and to discuss the clinical use of PSI in ischemic stroke.
  
  
  METHODS
  Thirty patients with clinically suspected acute infarction of the middle cerebral artery (MCA) territory within 7 days of onset were evaluated. Phase-sensitive imaging (PSI), flow-sensitive alternating inversion recovery (FAIR), diffusion-weighted imaging (DWI) and magnetic resonance angiography (MRA) were obtained using 3 Tesla scanner. Two neuroradiologists independently reviewed the MR images, as well as the PSI, DWI, and FAIR images. They were blinded to the clinical data and to each other's findings. The abnormal area of each image was ultimately identified after both neuroradiologists reached consensus. We analyzed areas of increased venous contrast on PSI, perfusion changes on FAIR images and signal changes on DWI for each case.
  
  
  RESULTS
  Venous contrast increased on PSI and hypoperfusion was evident on FAIR images from 22 of the 30 patients (73%). The distribution of the increased venous contrast was the same as that of the hypoperfused areas on FAIR images in 16 of these 22. The extent of these lesions was larger than that of lesions visualized by on DWI in 18 of the 22 patients. Hypointense signals reflecting hemorrhage and no increased venous contrast on PSI and hyperperfusion on FAIR images were found in six of the remaining eight patients (20%). Findings on PSI were normal and hypoperfusion areas were absent on FAIR images of two patients (7%).
  
  
  CONCLUSIONS
  Increased venous contrast on PSI might serve as an index of misery perfusion and provide useful information.
authors.affiliation: Division of Radiology, Department of Pathophysiological and Therapeutic Science, Faculty of Medicine, Japan. eyamashi-ttr@umin.ac.jp
authors.forename: Eijiro
authors.initials: E
authors.lastname: Yamashita
authors.forename: Yoshiko
authors.initials: Y
authors.lastname: Kanasaki
authors.forename: Shinya
authors.initials: S
authors.lastname: Fujii
authors.forename: Takuro
authors.initials: T
authors.lastname: Tanaka
authors.forename: Yoshiharu
authors.initials: Y
authors.lastname: Hirata
authors.forename: Toshihide
authors.initials: T
authors.lastname: Ogawa
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002545:Brain Ischemia / Q000175:diagnosis*; D002560:Cerebrovascular Circulation; D002648:Child; D038524:Diffusion Magnetic Resonance Imaging; D005260:Female; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D018810:Magnetic Resonance Angiography; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D020768:Middle Cerebral Artery; D012189:Retrospective Studies