title: Proximal Bright Vessel Sign on Arterial Spin Labeling Magnetic Resonance Imaging in Acute Cardioembolic Cerebral Infarction.
abstract: BACKGROUND
  The congestion of spin-labeled blood at large-vessel occlusion can present as hyperintense signals on perfusion magnetic resonance imaging with 3-dimensional pseudo-continuous arterial spin labeling (proximal bright vessel sign). The purpose of this study was to clarify the difference between proximal bright vessel sign and susceptibility vessel sign in acute cardioembolic cerebral infarction.
  
  
  METHODS
  Forty-two patients with cardioembolic cerebral infarction in the anterior circulation territory underwent magnetic resonance imaging including diffusion-weighted imaging, 3-dimensional pseudo-continuous arterial spin labeling perfusion magnetic resonance imaging, T2*-weighted imaging, and 3-dimensional time-of-flight magnetic resonance angiography using a 3-T magnetic resonance scanner. Visual assessments of proximal bright vessel sign and the susceptibility vessel sign were performed by consensus of 2 experienced neuroradiologists. The relationship between these signs and the occlusion site of magnetic resonance angiography was also investigated.
  
  
  RESULTS
  Among 42 patients with cardioembolic cerebral infarction, 24 patients showed proximal bright vessel sign (57.1%) and 25 showed susceptibility vessel sign (59.5%). There were 19 cases of proximal bright vessel sign and susceptibility vessel sign-clear, 12 cases of proximal bright vessel sign and susceptibility vessel sign-unclear, and 11 mismatched cases. Four out of 6 patients with proximal bright vessel sign-unclear and susceptibility vessel sign-clear showed distal middle cerebral artery occlusion, and 2 out of 5 patients with proximal bright vessel sign-clear and susceptibility vessel sign-unclear showed no occlusion on magnetic resonance angiography.
  
  
  CONCLUSIONS
  Proximal bright vessel sign is almost compatible with susceptibility vessel sign in patients with cardioembolic cerebral infarction.
authors.affiliation: Division of Radiology, Department of Pathophysiological and Therapeutic Science, Faculty of Medicine, Tottori University, Japan.
authors.forename: Ayumi
authors.initials: A
authors.lastname: Kato
authors.affiliation: Division of Radiology, Department of Pathophysiological and Therapeutic Science, Faculty of Medicine, Tottori University, Japan. Electronic address: shino-y@olive.plala.or.jp.
authors.forename: Yuki
authors.initials: Y
authors.lastname: Shinohara
authors.affiliation: Division of Radiology, Department of Pathophysiological and Therapeutic Science, Faculty of Medicine, Tottori University, Japan.
authors.forename: Keita
authors.initials: K
authors.lastname: Kuya
authors.affiliation: Division of Neurosurgery, Department of Brain and Neurosciences, Faculty of Medicine, Tottori University, Japan.
authors.forename: Makoto
authors.initials: M
authors.lastname: Sakamoto
authors.affiliation: Division of Neurology, Department of Brain and Neurosciences, Faculty of Medicine, Tottori University, Japan.
authors.forename: Hisanori
authors.initials: H
authors.lastname: Kowa
authors.affiliation: Division of Radiology, Department of Pathophysiological and Therapeutic Science, Faculty of Medicine, Tottori University, Japan.
authors.forename: Toshihide
authors.initials: T
authors.lastname: Ogawa
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002544:Cerebral Infarction / Q000000981:diagnostic imaging* / Q000209:etiology; D038524:Diffusion Magnetic Resonance Imaging / Q000379:methods*; D004617:Embolism / Q000150:complications* / Q000175:diagnosis; D005260:Female; D006331:Heart Diseases / Q000150:complications* / Q000175:diagnosis; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D020766:Intracranial Embolism / Q000000981:diagnostic imaging* / Q000209:etiology; D018810:Magnetic Resonance Angiography / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D015203:Reproducibility of Results; D012189:Retrospective Studies; D013113:Spin Labels
chemical_list: D013113:Spin Labels
keywords: Cardioembolic infarction; arterial spin labeling; large-vessel occlusion; magnetic resonance imaging