title: Validation of hyperintense middle cerebral artery sign in acute ischemic stroke: Comparison between magnetic resonance imaging and angiography.
abstract: We performed a retrospective analysis of non-contrast computed tomography (CT) scans, immediately subsequent magnetic resonance imaging (MRI), and cerebral angiography data from 30 consecutive patients with acute ischemic stroke within 6 hours after symptom onset. Results showed that eleven patients developed subsequent hemorrhagic transformation at follow-up. A hyperintense middle cerebral artery sign on MRI was found in six hemorrhagic patients, all of who had acute thrombosis formation on magnetic resonance angiography and digital subtraction angiography. No patients in the non-hemorrhagic group had hyperintense middle cerebral artery sign on MRI. The sensitivity, specificity, and positive predictive values of the hyperintense middle cerebral artery sign on MRI T1-weighted image for subsequent hemorrhagic transformation were 54.5%, 100%, and 100% respectively. Hyperdense middle cerebral artery sign on non-contrast CT was observed in nine patients, five of who developed hemorrhagic transformation. These data suggest that hyperintense middle cerebral artery sign on MRI T1-weighted image is a highly specific and moderately sensitive indicator of subsequent hemorrhagic transformation in patients after acute ischemic stroke, and its specificity is superior to CT.
authors.affiliation: Department of Radiology, Xiamen Second Hospital, Teaching Hospital of Fujian Medical University, Xiamen 361021, Fujian Province, China.
authors.forename: Gang
authors.initials: G
authors.lastname: Guo
authors.affiliation: Department of Radiology, Xiamen Second Hospital, Teaching Hospital of Fujian Medical University, Xiamen 361021, Fujian Province, China.
authors.forename: Yonggui
authors.initials: Y
authors.lastname: Yang
authors.affiliation: Department of Radiology, Xiamen Second Hospital, Teaching Hospital of Fujian Medical University, Xiamen 361021, Fujian Province, China.
authors.forename: Weiqun
authors.initials: W
authors.lastname: Yang
keywords: angiography; hemorrhagic transformation; magnetic resonance imaging; stroke