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PT  - JOURNAL ARTICLE
AU  - Shang, W.J.
AU  - Chen, H.B.
AU  - Shu, L.M.
AU  - Liao, H.Q.
AU  - Huang, X.Y.
AU  - Xiao, S.
AU  - Hong, H.
TI  - The Association between FLAIR Vascular Hyperintensity and Stroke Outcome Varies with Time from Onset
AID  - 10.3174/ajnr.A6142
DP  - 2019 Aug 01
TA  - American Journal of Neuroradiology
PG  - 1317--1322
VI  - 40
IP  - 8
4099  - http://www.ajnr.org/content/40/8/1317.short
4100  - http://www.ajnr.org/content/40/8/1317.full
SO  - Am. J. Neuroradiol.2019 Aug 01; 40
AB  - BACKGROUND AND PURPOSE: FLAIR vascular hyperintensity has been recognized as a marker of collaterals in ischemic stroke, but the impact on outcome is still controversial. We hypothesized that the association between FLAIR vascular hyperintensity and outcome varies with time.MATERIALS AND METHODS: We included 459 consecutive patients with middle cerebral artery stroke and divided them into 3 groups by symptom-to-MR imaging time (group 1, ≤7 days; group 2, 8–14 days; group 3, ≥15 days). The FLAIR vascular hyperintensity score, ranging from 0 to 3 points, was based on territory distributions of different MCA segments. The associations between FLAIR vascular hyperintensity and outcome with time were analyzed qualitatively and quantitatively.RESULTS: No patients underwent MR imaging within 6 hours of onset. The proportion of FLAIR vascular hyperintensity (+) and severe stenosis or occlusion of MCA was not significantly dependent on time. In groups 1 and 2, FLAIR vascular hyperintensity (+) was significantly associated with larger lesions, the prevalence of flow injury, and unfavorable outcome (mRS ≥ 2). There were no such associations in group 3. Multiple logistic regressions demonstrated that FLAIR vascular hyperintensity (+) was an independent risk factor for unfavorable outcome in group 2. Infarction volume tended to increase with the increase of the distal FLAIR vascular hyperintensity score in groups 1 and 2, while declining in group 3.CONCLUSIONS: FLAIR vascular hyperintensity is associated with unfavorable outcome within 6 hours to 14 days of onset, while the wider distribution of distal FLAIR vascular hyperintensity may be favorable beyond 14 days of onset in MCA infarction. Symptom-to-MR imaging time should be considered when assessing the prognostic value of FLAIR vascular hyperintensity.FVHFLAIR vascular hyperintensity