title: Sequential MR Assessment of the Susceptibility Vessel Sign and Arterial Occlusion in Acute Stroke.
abstract: Susceptibility vessel sign (SVS) may likely influence recanalization after thrombolysis. We assessed, through the European sequential MRI database "I-KNOW," the relationship between the presence of SVS on T2-weighted gradient echo imaging, its angiographic counterpart on magnetic resonance angiography and its subsequent impact on recanalization after thrombolysis.
  
  
  
  Initial clinical and MRI characteristics and early follow up were analyzed in acute ischemic stroke patients treated with rt-Pa within 4.5 hours. Patients underwent multimodal MRI at admission. Sequential imaging performed 3 hours, 2 days and 1 month later allowed the analysis of SVS changes and recanalization.
  
  
  
  Fifty patients were included in the study. SVS was observed in 54% of cases at admission. SVS was still present in 46% patients at 3 hours, 16% at 2 days, and 0% at 1 month. It was an independent predictor of no recanalization after thrombolysis (P = .04). After 3 hours, SVS disappeared in only 4 cases, and was not linked with recanalization on MRA. Conversely, when SVS persisted, a partial or complete recanalization was observed in 9 and 6 cases, respectively.
  
  
  
  SVS is a predictor of lower recanalization rate. Its disappearance is not necessarily correlated with recanalization.
authors.affiliation: Cerebrovascular Unit, Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, 69677, Bron Cedex, France.|Université de Lyon CREATIS, CNRS UMR5220, INSERM U1044, INSA-Lyon, Université Lyon 1, Hospices Civils de Lyon, France.
authors.forename: Thomas
authors.initials: T
authors.lastname: Ritzenthaler
authors.affiliation: Neuroradiology Department, Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, 69677, Bron Cedex, France.
authors.forename: Audrey
authors.initials: A
authors.lastname: Lacalm
authors.affiliation: Cerebrovascular Unit, Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, 69677, Bron Cedex, France.|Université de Lyon CREATIS, CNRS UMR5220, INSERM U1044, INSA-Lyon, Université Lyon 1, Hospices Civils de Lyon, France.
authors.forename: Tae-Hee
authors.initials: TH
authors.lastname: Cho
authors.affiliation: Service de Biostatistiques, Hospices Civils de Lyon, Lyon 69003, France; CNRS UMR 5558, Equipe Biostatistique Santé, Pierre-Bénite, F-69310, France; Université Lyon I, Villeurbanne, F-69100, France.
authors.forename: Delphine
authors.initials: D
authors.lastname: Maucort-Boulch
authors.affiliation: Department of Clinical Medicine, Center of Functionally Integrative Neuroscience, Aarhus University, Aarhus, Denmark.
authors.forename: Irene
authors.initials: I
authors.lastname: Klaerke Mikkelsen
authors.affiliation: Department of Clinical Medicine, Center of Functionally Integrative Neuroscience, Aarhus University, Aarhus, Denmark.
authors.forename: Lars
authors.initials: L
authors.lastname: Ribe
authors.affiliation: Department of Clinical Medicine, Center of Functionally Integrative Neuroscience, Aarhus University, Aarhus, Denmark.
authors.forename: Leif
authors.initials: L
authors.lastname: Østergaard
authors.affiliation: Department of Clinical Medicine, Center of Functionally Integrative Neuroscience, Aarhus University, Aarhus, Denmark.
authors.forename: Niels
authors.initials: N
authors.lastname: Hjort
authors.affiliation: Departments of Diagnostic and Interventional Neuroradiology, University Hospital Hamburg-Eppendorf, Hamburg, Germany.
authors.forename: Jens
authors.initials: J
authors.lastname: Fiehler
authors.affiliation: Department of Radiology (IDI), Girona Biomedical Research Institute (IDIBGI), Hospital Universitari de Girona Dr Josep Trueta, Girona, Spain.
authors.forename: Salvador
authors.initials: S
authors.lastname: Pedraza
authors.affiliation: Neuroradiology Department, Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, 69677, Bron Cedex, France.
authors.forename: Guy
authors.initials: G
authors.lastname: Louis Tisserand
authors.affiliation: INSERM U894, Université Paris Descartes, Sorbonne Paris Cité, France.
authors.forename: Jean-Claude
authors.initials: JC
authors.lastname: Baron
authors.affiliation: Neuroradiology Department, Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, 69677, Bron Cedex, France.|Université de Lyon CREATIS, CNRS UMR5220, INSERM U1044, INSA-Lyon, Université Lyon 1, Hospices Civils de Lyon, France.
authors.forename: Yves
authors.initials: Y
authors.lastname: Berthezene
authors.affiliation: Cerebrovascular Unit, Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, 69677, Bron Cedex, France.|Université de Lyon CREATIS, CNRS UMR5220, INSERM U1044, INSA-Lyon, Université Lyon 1, Hospices Civils de Lyon, France.
authors.forename: Norbert
authors.initials: N
authors.lastname: Nighoghossian
mesh_terms: D000368:Aged; D005260:Female; D006454:Hemoglobins / Q000378:metabolism; D006801:Humans; D018810:Magnetic Resonance Angiography / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D013223:Statistics as Topic; D020521:Stroke / Q000000981:diagnostic imaging* / Q000188:drug therapy*; D015912:Thrombolytic Therapy; D010959:Tissue Plasminogen Activator / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D006454:Hemoglobins; C100003:deoxyhemoglobin; D010959:Tissue Plasminogen Activator
keywords: MRI; acute ischemic stroke; gradient echo imaging