title: Distal hyperintense vessels on FLAIR images predict large-artery stenosis in patients with transient ischemic attack.
abstract: BACKGROUND
  Distal hyperintense vessels (DHV) are frequently detected by fluid-attenuated inversion recovery (FLAIR) imaging in patients with acute ischemic stroke. Despite its relevance to patient care outcomes, the presence of DHV has not been evaluated in patients with transient ischemic attack (TIA).
  
  
  METHODS
  We performed a retrospective analysis of all TIA patients admitted to the study hospital from 2006 to 2010 who had undergone magnetic resonance imaging (MRI) within 24 h of symptom onset followed by further intracranial and extracranial vascular imaging. We then analyzed the relationship between DHV, large artery severe stenosis or occlusion (LASO), and clinical presentation.
  
  
  RESULTS
  Forty-three TIA patients were enrolled in this study. DHV signals on FLAIR images were positive in 14 (33 %) patients. Patients with DHV were significantly more likely to have severe stenosis or occlusion in intracranial (P = 0.01) and extracranial vessels (P = 0.04) than patients without DHV. DHV was associated independently with LASO (odds ratio = 6.1; 95 % CI, 1.2-31.5).
  
  
  CONCLUSIONS
  Evaluation of DHV signals on FLAIR images may facilitate prediction of LASO in TIA patients and therefore enable prompt vascular assessment.
authors.affiliation: Department of Neurology and Neurological Science, Tokyo Medical and Dental University, 1-5-45, Yushima, Bunkyo-ku, Tokyo 113-0034, Japan. kotanuro@tmd.ac.jp
authors.forename: Kotaro
authors.initials: K
authors.lastname: Yoshioka
authors.forename: Satoru
authors.initials: S
authors.lastname: Ishibashi
authors.forename: Atsushi
authors.initials: A
authors.lastname: Shiraishi
authors.forename: Takanori
authors.initials: T
authors.lastname: Yokota
authors.forename: Hidehiro
authors.initials: H
authors.lastname: Mizusawa
mesh_terms: D000368:Aged; D002533:Cerebral Angiography / Q000379:methods*; D002539:Cerebral Arterial Diseases / Q000150:complications* / Q000175:diagnosis*; D002536:Cerebral Arteries / Q000473:pathology*; D003251:Constriction, Pathologic / Q000473:pathology; D005260:Female; D006801:Humans; D002546:Ischemic Attack, Transient / Q000150:complications* / Q000175:diagnosis*; D018810:Magnetic Resonance Angiography / Q000379:methods*; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity