title: M1 susceptibility vessel sign and hyperdense middle cerebral artery sign in hyperacute stroke patients.
abstract: OBJECTIVE
  Vessel signs, such as the susceptibility vessel sign (SVS) on T2*-gradient echo imaging (T2*) and the hyperdense middle cerebral artery sign (HMCAS) on CT, are well-known markers of arterial occlusion. However, the relationship between the signs is not fully known.
  
  
  METHODS
  Patients suspected of having hyperacute (<3 h from symptom onset) stroke were prospectively enrolled. MRI including T2* and MR angiography, and thin-section CT were performed on admission. The consistency between SVS and HMCAS were evaluated.
  
  
  RESULTS
  A total of 67 patients [38 males, median age: 76 (interquartile range: 67-82) years, median NIHSS score: 12 (4-21)] were enrolled. SVS was observed in 6 patients (9%), and HMCAS was present in 8 (12%). Sixteen patients (24%) had middle cerebral artery proximal (M1) occlusion on MR angiography. The presence or absence of SVS was highly consistent with that of HMCAS when all cases were evaluated (ĸ = 0.841), as well as when only patients with M1 occlusion were assessed (ĸ = 0.750).
  
  
  CONCLUSIONS
  SVS and HMCAS were highly consistent with each other in suspected hyperacute stroke patients. SVS and HMCAS may represent the same thrombus.
authors: Department of Stroke Medicine, Kawasaki Medical School, Kurashiki, Japan. ysakamoto02@gmail.com
authors: Yuki
authors: Y
authors: Sakamoto
authors: Kazumi
authors: K
authors: Kimura
authors: Kenichiro
authors: K
authors: Sakai
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D020244:Infarction, Middle Cerebral Artery / Q000473:pathology*; D018810:Magnetic Resonance Angiography; D008279:Magnetic Resonance Imaging; D008297:Male; D020768:Middle Cerebral Artery / Q000473:pathology*; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D020521:Stroke / Q000175:diagnosis / Q000473:pathology*; D014057:Tomography, X-Ray Computed