title: Early Stage of Hyperintense Acute Reperfusion Marker on Contrast-Enhanced FLAIR Images in Patients With Acute Stroke.
abstract: OBJECTIVE
  Hyperintense acute reperfusion marker (HARM) is defined as delayed CSF enhancement on FLAIR images in patients with acute stroke and was observed in follow-up FLAIR images after initial MRI with contrast material administration. We hypothesized that different imaging findings of HARM could be present depending on the timing of FLAIR imaging after contrast material administration.
  
  
  METHODS
  Of 218 consecutive patients with acute stroke or transient ischemic attack over 3 months, 12 with linear contrast enhancement on the cortical surface in initial FLAIR images underwent serial FLAIR imaging. Initial FLAIR images were obtained 5 minutes after contrast material administration, and follow-up unenhanced FLAIR images were obtained 2.5-29 hours (mean, 13.2 hours) after initial FLAIR imaging. The enhancement patterns between initial and follow-up FLAIR images were compared.
  
  
  RESULTS
  In all 12 patients, initial contrast-enhanced FLAIR images showed focal or multifocal linear contrast enhancement along the cortical surface near acute infarctions. On follow-up unenhanced FLAIR images, initial cortical enhancement spread diffusely and filled the subarachnoid space.
  
  
  CONCLUSIONS
  HARM in acute stroke can be detected earlier than previously reported on initial contrast-enhanced FLAIR images. Different imaging findings of HARM depend on the timing of FLAIR imaging after contrast material administration.
authors.affiliation: 1 Department of Radiology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, 173-82 Gumi-ro, Bundang-gu, Seongnam-si, Gyeonggi-do, 463-707, Korea.|2 Present address: Department of Radiology, Kyung Hee University College of Medicine, Kyung Hee University Hospital, Seoul, Korea.
authors.forename: Kyung Mi
authors.initials: KM
authors.lastname: Lee
authors.affiliation: 1 Department of Radiology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, 173-82 Gumi-ro, Bundang-gu, Seongnam-si, Gyeonggi-do, 463-707, Korea.
authors.forename: Jae Hyoung
authors.initials: JH
authors.lastname: Kim
authors.affiliation: 1 Department of Radiology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, 173-82 Gumi-ro, Bundang-gu, Seongnam-si, Gyeonggi-do, 463-707, Korea.
authors.forename: Eunhee
authors.initials: E
authors.lastname: Kim
authors.affiliation: 1 Department of Radiology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, 173-82 Gumi-ro, Bundang-gu, Seongnam-si, Gyeonggi-do, 463-707, Korea.
authors.forename: Byung Se
authors.initials: BS
authors.lastname: Choi
authors.affiliation: 1 Department of Radiology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, 173-82 Gumi-ro, Bundang-gu, Seongnam-si, Gyeonggi-do, 463-707, Korea.
authors.forename: Yun Jung
authors.initials: YJ
authors.lastname: Bae
authors.affiliation: 3 Department of Neurology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam-si, Korea.
authors.forename: Hee-Joon
authors.initials: HJ
authors.lastname: Bae
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002545:Brain Ischemia / Q000000981:diagnostic imaging*; D003287:Contrast Media / Q000008:administration & dosage; D004334:Drug Administration Schedule; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009942:Organometallic Compounds / Q000008:administration & dosage; D011446:Prospective Studies; D020521:Stroke / Q000000981:diagnostic imaging*
chemical_list: D003287:Contrast Media; D009942:Organometallic Compounds; C090600:gadobutrol
keywords: acute ischemic stroke; blood-brain barrier; contrast-enhanced FLAIR image; hyperintense acute reperfusion marker