Venous imaging-based biomarkers in acute ischaemic stroke.
Vascular neuroimaging plays a decisive role in selecting the best therapy in patients with acute ischaemic stroke. However, compared with the arterial system, the role of veins has not been thoroughly studied. In this review, we present the major venous imaging-based biomarkers in ischaemic stroke. First, the presence of hypodense veins in the monophasic CT angiography ipsilateral to the arterial occlusion. Second, the asymmetry of venous drainage in the pathological cerebral hemisphere on CT and MRI dynamic angiography. Finally, the presence of hypodense veins on T2* -based MRI. From the physiological point of view, the venous imaging-based biomarkers would detect the alteration of brain perfusion (flow), as well as the optimisation of extraction oxygen mechanisms (misery perfusion). Several studies have correlated the venous imaging-based biomarkers with grade of collateral circulation, the ischaemic penumbra and clinical functional outcome. Although venous imaging-based biomarkers still have to be validated, growing evidence highlights a potential complementary role in the acute stroke clinical decision-making process.
Diagnostic Imaging Institute (IDI), Germans Trias i Pujol University Hospital, Badalona, Spain.
Josep
http://orcid.org/0000-0001-5154-1796
J
Munuera
Institute of Diagnostic Imaging (IDI)-Research Unit (IDIR), Girona, Spain.|Girona Biomedical Research Institute (IDIBGI)-Medical Imaging, Girona, Spain.
Gerard
G
Blasco
Stroke Unit, Germans Trias i Pujol University Hospital, Badalona, Spain.
María
M
Hernández-Pérez
Department of Computer Science, Applied Mathematics and Statistics, University of Girona, Girona, Spain.
Pepus
http://orcid.org/0000-0001-6134-9255
P
Daunis-I-Estadella
Stroke Unit, Germans Trias i Pujol University Hospital, Badalona, Spain.
Antoni
A
Dávalos
Neurovascular Imaging Research Core and UCLA Stroke Center, Los Angeles, California, USA.
David S
DS
Liebeskind
Department of Radiology, Neuroradiology Division, Stanford University, Stanford, California, USA.
Max
M
Wintermark
Calgary Stroke Program, Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada.
Andrew
A
Demchuk
Calgary Stroke Program, Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada.
Bijoy K
BK
Menon
Department of Neurology, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany.
Götz
G
Thomalla
Department of Radiology, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
Kambiz
K
Nael
Girona Biomedical Research Institute (IDIBGI)-Medical Imaging, Girona, Spain.|Institute of Diagnostic Imaging (IDI)-Dr. Josep Trueta University Hospital, Girona, Spain.
Salvador
S
Pedraza
Institute of Diagnostic Imaging (IDI)-Research Unit (IDIR), Girona, Spain.|Girona Biomedical Research Institute (IDIBGI)-Medical Imaging, Girona, Spain.
Josep
J
Puig
D015415:Biomarkers / Q000032:analysis; D002545:Brain Ischemia / Q000150:complications / Q000000981:diagnostic imaging*; D002533:Cerebral Angiography / Q000379:methods*; D002550:Cerebral Veins / Q000000981:diagnostic imaging*; D006801:Humans; D008279:Magnetic Resonance Imaging; D059906:Neuroimaging; D020521:Stroke / Q000150:complications / Q000000981:diagnostic imaging*; D014057:Tomography, X-Ray Computed
D015415:Biomarkers
MRI; STROKE