title: Bright vessel appearance on arterial spin labeling MRI for localizing arterial occlusion in acute ischemic stroke.
abstract: OBJECTIVE
  The purpose of this study was to evaluate whether bright vessel appearance on arterial spin labeling (ASL) MRI can help localize arterial occlusion sites in patients with acute ischemic stroke.
  
  
  METHODS
  Patients who underwent MRI for suspected acute ischemic stroke, as identified by an area of restricted diffusion, were included. All images were visually analyzed for the presence or absence of (1) arterial occlusion on time-of-flight MR angiography, (2) bright vessel appearance on ASL images, and (3) susceptibility vessel sign. McNemar 2-tailed test was used to compare the sensitivities of ASL and susceptibility-weighted imaging for the detection of arterial occlusion, using MR angiography as the reference standard.
  
  
  RESULTS
  ASL bright vessel appearance was significantly more common in the group with occlusion than in the group without occlusion (94% [33 of 35] versus 21% [17 of 82], respectively; P<0.001). The bright vessel appearance, when present, was seen proximal or distal to the occlusion site. The bright vessel appearance had a significantly higher sensitivity for the detection of occlusion than the susceptibility vessel sign (94% [33 of 35] versus 66% [23 of 35], respectively; P=0.002). In cases with negative MR angiography, the bright vessel appearance helped identify more additional arterial occlusions than the susceptibility vessel sign (21% [17 of 82] versus 10% [8 of 82], respectively; P=0.012).
  
  
  CONCLUSIONS
  The bright vessel appearance on ASL imaging can provide an important diagnostic clue for the detection and localization of arterial occlusion sites in patients with acute ischemic stroke.
authors.affiliation: From the Institute of Radiation Medicine, Seoul National University Medical Research Center, Seoul, Republic of Korea (R.-E.Y., T.J.Y., J.H.R., K.M.K., S.H.C., J.-H.K., C.-H.S., M.H.H.); Department of Radiology (R.-E.Y., T.J.Y., J.H.R., K.M.K., S.H.C., J.-H.K., C.-H.S., M.H.H.), Clinical Research Center for Stroke, Clinical Research Institute (B.-W.Y.), Department of Neurology (B.-W.Y.), and Department of Neurosurgery (J.E.K., H.-S.K.), Seoul National University Hospital, Seoul, Republic of Korea.
authors.forename: Roh-Eul
authors.initials: RE
authors.lastname: Yoo
authors.affiliation: From the Institute of Radiation Medicine, Seoul National University Medical Research Center, Seoul, Republic of Korea (R.-E.Y., T.J.Y., J.H.R., K.M.K., S.H.C., J.-H.K., C.-H.S., M.H.H.); Department of Radiology (R.-E.Y., T.J.Y., J.H.R., K.M.K., S.H.C., J.-H.K., C.-H.S., M.H.H.), Clinical Research Center for Stroke, Clinical Research Institute (B.-W.Y.), Department of Neurology (B.-W.Y.), and Department of Neurosurgery (J.E.K., H.-S.K.), Seoul National University Hospital, Seoul, Republic of Korea. radiologyyun@gmail.com.
authors.forename: Tae Jin
authors.initials: TJ
authors.lastname: Yun
authors.affiliation: From the Institute of Radiation Medicine, Seoul National University Medical Research Center, Seoul, Republic of Korea (R.-E.Y., T.J.Y., J.H.R., K.M.K., S.H.C., J.-H.K., C.-H.S., M.H.H.); Department of Radiology (R.-E.Y., T.J.Y., J.H.R., K.M.K., S.H.C., J.-H.K., C.-H.S., M.H.H.), Clinical Research Center for Stroke, Clinical Research Institute (B.-W.Y.), Department of Neurology (B.-W.Y.), and Department of Neurosurgery (J.E.K., H.-S.K.), Seoul National University Hospital, Seoul, Republic of Korea.
authors.forename: Jung Hyo
authors.initials: JH
authors.lastname: Rhim
authors.affiliation: From the Institute of Radiation Medicine, Seoul National University Medical Research Center, Seoul, Republic of Korea (R.-E.Y., T.J.Y., J.H.R., K.M.K., S.H.C., J.-H.K., C.-H.S., M.H.H.); Department of Radiology (R.-E.Y., T.J.Y., J.H.R., K.M.K., S.H.C., J.-H.K., C.-H.S., M.H.H.), Clinical Research Center for Stroke, Clinical Research Institute (B.-W.Y.), Department of Neurology (B.-W.Y.), and Department of Neurosurgery (J.E.K., H.-S.K.), Seoul National University Hospital, Seoul, Republic of Korea.
authors.forename: Byung-Woo
authors.initials: BW
authors.lastname: Yoon
authors.affiliation: From the Institute of Radiation Medicine, Seoul National University Medical Research Center, Seoul, Republic of Korea (R.-E.Y., T.J.Y., J.H.R., K.M.K., S.H.C., J.-H.K., C.-H.S., M.H.H.); Department of Radiology (R.-E.Y., T.J.Y., J.H.R., K.M.K., S.H.C., J.-H.K., C.-H.S., M.H.H.), Clinical Research Center for Stroke, Clinical Research Institute (B.-W.Y.), Department of Neurology (B.-W.Y.), and Department of Neurosurgery (J.E.K., H.-S.K.), Seoul National University Hospital, Seoul, Republic of Korea.
authors.forename: Koung Mi
authors.initials: KM
authors.lastname: Kang
authors.affiliation: From the Institute of Radiation Medicine, Seoul National University Medical Research Center, Seoul, Republic of Korea (R.-E.Y., T.J.Y., J.H.R., K.M.K., S.H.C., J.-H.K., C.-H.S., M.H.H.); Department of Radiology (R.-E.Y., T.J.Y., J.H.R., K.M.K., S.H.C., J.-H.K., C.-H.S., M.H.H.), Clinical Research Center for Stroke, Clinical Research Institute (B.-W.Y.), Department of Neurology (B.-W.Y.), and Department of Neurosurgery (J.E.K., H.-S.K.), Seoul National University Hospital, Seoul, Republic of Korea.
authors.forename: Seung Hong
authors.initials: SH
authors.lastname: Choi
authors.affiliation: From the Institute of Radiation Medicine, Seoul National University Medical Research Center, Seoul, Republic of Korea (R.-E.Y., T.J.Y., J.H.R., K.M.K., S.H.C., J.-H.K., C.-H.S., M.H.H.); Department of Radiology (R.-E.Y., T.J.Y., J.H.R., K.M.K., S.H.C., J.-H.K., C.-H.S., M.H.H.), Clinical Research Center for Stroke, Clinical Research Institute (B.-W.Y.), Department of Neurology (B.-W.Y.), and Department of Neurosurgery (J.E.K., H.-S.K.), Seoul National University Hospital, Seoul, Republic of Korea.
authors.forename: Ji-Hoon
authors.initials: JH
authors.lastname: Kim
authors.affiliation: From the Institute of Radiation Medicine, Seoul National University Medical Research Center, Seoul, Republic of Korea (R.-E.Y., T.J.Y., J.H.R., K.M.K., S.H.C., J.-H.K., C.-H.S., M.H.H.); Department of Radiology (R.-E.Y., T.J.Y., J.H.R., K.M.K., S.H.C., J.-H.K., C.-H.S., M.H.H.), Clinical Research Center for Stroke, Clinical Research Institute (B.-W.Y.), Department of Neurology (B.-W.Y.), and Department of Neurosurgery (J.E.K., H.-S.K.), Seoul National University Hospital, Seoul, Republic of Korea.
authors.forename: Jeong Eun
authors.initials: JE
authors.lastname: Kim
authors.affiliation: From the Institute of Radiation Medicine, Seoul National University Medical Research Center, Seoul, Republic of Korea (R.-E.Y., T.J.Y., J.H.R., K.M.K., S.H.C., J.-H.K., C.-H.S., M.H.H.); Department of Radiology (R.-E.Y., T.J.Y., J.H.R., K.M.K., S.H.C., J.-H.K., C.-H.S., M.H.H.), Clinical Research Center for Stroke, Clinical Research Institute (B.-W.Y.), Department of Neurology (B.-W.Y.), and Department of Neurosurgery (J.E.K., H.-S.K.), Seoul National University Hospital, Seoul, Republic of Korea.
authors.forename: Hyun-Seung
authors.initials: HS
authors.lastname: Kang
authors.affiliation: From the Institute of Radiation Medicine, Seoul National University Medical Research Center, Seoul, Republic of Korea (R.-E.Y., T.J.Y., J.H.R., K.M.K., S.H.C., J.-H.K., C.-H.S., M.H.H.); Department of Radiology (R.-E.Y., T.J.Y., J.H.R., K.M.K., S.H.C., J.-H.K., C.-H.S., M.H.H.), Clinical Research Center for Stroke, Clinical Research Institute (B.-W.Y.), Department of Neurology (B.-W.Y.), and Department of Neurosurgery (J.E.K., H.-S.K.), Seoul National University Hospital, Seoul, Republic of Korea.
authors.forename: Chul-Ho
authors.initials: CH
authors.lastname: Sohn
authors.affiliation: From the Institute of Radiation Medicine, Seoul National University Medical Research Center, Seoul, Republic of Korea (R.-E.Y., T.J.Y., J.H.R., K.M.K., S.H.C., J.-H.K., C.-H.S., M.H.H.); Department of Radiology (R.-E.Y., T.J.Y., J.H.R., K.M.K., S.H.C., J.-H.K., C.-H.S., M.H.H.), Clinical Research Center for Stroke, Clinical Research Institute (B.-W.Y.), Department of Neurology (B.-W.Y.), and Department of Neurosurgery (J.E.K., H.-S.K.), Seoul National University Hospital, Seoul, Republic of Korea.
authors.forename: Moon Hee
authors.initials: MH
authors.lastname: Han
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002545:Brain Ischemia / Q000175:diagnosis* / Q000378:metabolism*; D002561:Cerebrovascular Disorders / Q000175:diagnosis / Q000378:metabolism; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013113:Spin Labels; D020521:Stroke / Q000175:diagnosis* / Q000378:metabolism*
chemical_list: D013113:Spin Labels
keywords: ischemia; perfusion imaging; stroke