Fluid-attenuated inversion recovery images and stroke outcome after thrombolysis.
OBJECTIVE
We investigated if hyperintensities on fluid-attenuated inversion recovery (FLAIR) sequences in arteries and parenchyma are associated with poor outcome 3 months after thrombolysis.


METHODS
Consecutive acute stroke patients with known time of symptom onset who had an MRI before and 1 day after thrombolysis were included in this study. Blinded to follow-up imaging and outcome, 2 raters independently judged the presence or absence of arterial and parenchymal FLAIR hyperintensities. Functional outcome (modified Rankin Scale) was assessed after 3 months.


RESULTS
Out of 90 patients, 22 had parenchymal FLAIR hyperintensities and 42 had hyperintense vessels. The combination of FLAIR hyperintensities in arteries and parenchyma occurred in 15 patients. Stepwise forward regression analysis revealed an adjusted odds ratio of 14.5 for a worse outcome (modified Rankin Scale score >2) in patients with FLAIR hyperintensities in arteries and parenchyma (95% confidence interval, 1.3-158.5; P=0.03).


CONCLUSIONS
FLAIR hyperintensities in arteries and parenchyma are an easy-to-use MRI feature in acute ischemic stroke associated with poor outcome 3 months after thrombolysis.
CSB, Charité-Universitätsmedizin Berlin, Charitéplatz 1, 10117 Berlin, Germany. martin.ebinger@charite.de
Martin
M
Ebinger
Anna
A
Kufner
Ivana
I
Galinovic
Peter
P
Brunecker
Uwe
U
Malzahn
Christian H
CH
Nolte
Matthias
M
Endres
Jochen B
JB
Fiebach
D000368:Aged; D000369:Aged, 80 and over; D001921:Brain / Q000473:pathology; D002545:Brain Ischemia / Q000188:drug therapy / Q000473:pathology; D002536:Cerebral Arteries / Q000473:pathology; D005260:Female; D005343:Fibrinolytic Agents / Q000627:therapeutic use*; D006439:Hemodynamics / Q000502:physiology; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D016017:Odds Ratio; D020521:Stroke / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology*; D015912:Thrombolytic Therapy; D016896:Treatment Outcome
D005343:Fibrinolytic Agents