title: Is the Susceptibility Vessel Sign on 3-Tesla Magnetic Resonance T2*-Weighted Imaging a Useful Tool to Predict Recanalization in Intravenous Tissue Plasminogen Activator?
abstract: The aim of this study was to investigate the independent factors associated with the absence of recanalization approximately 24 h after intravenous administration of tissue-type plasminogen activator (IV TPA). The previous studies have been conducted using 1.5-Tesla (T) magnetic resonance imaging (MRI). We studied whether the characteristics of 3-T MRI findings were useful to predict outcome and recanalization after IV tPA. Patients with internal carotid artery (ICA) or middle cerebral artery (MCA) (horizontal portion, M1; Sylvian portion, M2) occlusion and treated by IV tPA were enrolled. We studied whether the presence of susceptibility vessel sign (SVS) at M1 and low clot burden score on T2*-weighted imaging (T2*-CBS) on 3-T MRI were associated with the absence of recanalization. A total of 49 patients were enrolled (27 men; mean age, 73.9 years). MR angiography obtained approximately 24 h after IV tPA revealed recanalization in 21 (42.9 %) patients. Independent factors associated with the absence of recanalization included ICA or proximal M1 occlusion (odds ratio, 69.6; 95 % confidence interval, 5.05-958.8, p = 0.002). In this study, an independent factor associated with the absence of recanalization may be proximal occlusion of the cerebral arteries rather than SVS in the MCA or low T2*-CBS on 3-T MRI.
authors.affiliation: Department of Clinical Neurosciences, Institute of Health Biosciences, The University of Tokushima Graduate School, Kuramoto-cho, 770-8503, Tokushima, Japan. nobyamamoto521129@yahoo.co.jp.
authors.forename: N
authors.initials: N
authors.lastname: Yamamoto
authors.affiliation: Department of Neurosurgery, Institute of Health Biosciences, Tokushima University, Tokushima, Japan.
authors.forename: J
authors.initials: J
authors.lastname: Satomi
authors.affiliation: Department of Radiology, Institute of Health Biosciences, Tokushima University, Tokushima, Japan.
authors.forename: M
authors.initials: M
authors.lastname: Harada
authors.affiliation: Department of Clinical Neurosciences, Institute of Health Biosciences, The University of Tokushima Graduate School, Kuramoto-cho, 770-8503, Tokushima, Japan.
authors.forename: Y
authors.initials: Y
authors.lastname: Izumi
authors.affiliation: Department of Neurosurgery, Institute of Health Biosciences, Tokushima University, Tokushima, Japan.
authors.forename: S
authors.initials: S
authors.lastname: Nagahiro
authors.affiliation: Department of Clinical Neurosciences, Institute of Health Biosciences, The University of Tokushima Graduate School, Kuramoto-cho, 770-8503, Tokushima, Japan.
authors.forename: R
authors.initials: R
authors.lastname: Kaji
mesh_terms: D000368:Aged; D038524:Diffusion Magnetic Resonance Imaging / Q000379:methods*; D005260:Female; D005343:Fibrinolytic Agents / Q000008:administration & dosage; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D007275:Injections, Intravenous; D018810:Magnetic Resonance Angiography / Q000379:methods*; D008297:Male; D017063:Outcome Assessment, Health Care / Q000379:methods*; D018579:Patient Selection; D011379:Prognosis; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D020521:Stroke / Q000000981:diagnostic imaging* / Q000188:drug therapy*; D010959:Tissue Plasminogen Activator / Q000008:administration & dosage*; D016896:Treatment Outcome
chemical_list: D005343:Fibrinolytic Agents; D010959:Tissue Plasminogen Activator
keywords: 3-Tesla MRI; Recanalization; T2*-WI; tPA