Susceptibility vessel sign on MRI predicts favorable clinical outcome in patients with anterior circulation acute stroke treated with mechanical thrombectomy

Abstract

BACKGROUND AND PURPOSE: The susceptibility vessel sign on MR imaging has been reported to indicate acute occlusion from erythrocyte-rich thrombus. The purpose of this study was to evaluate the influence of the susceptibility vessel sign seen on MR imaging before treatment on the clinical outcome after mechanical thrombectomy for anterior circulation acute stroke. MATERIALSANDMETHODS: Weretrospectively included 73 consecutive patients who were treated for anterior circulation acute stroke by mechanical thrombectomy from December 2009 to September 2013. Each patient underwent MR imaging before mechanical thrombectomy. The presence (susceptibility vessel sign <2 at 3 months in susceptibility vessel sign< and susceptibility vessel sign= groups. Patient clinical characteristics, initial NIHSS score and ASPECTS, site of occlusion, time between onset to groin puncture, TICI after mechanical thrombectomy, NIHSS score at day 1, and spontaneous hyperattenuation on CT at day 1 were also analyzed. RESULTS: Fifty-three patients with susceptibility vessel sign <2 at 3 months occurred in 65% patients in the susceptibility vessel sign.004). On multivariate analysis, the susceptibility vessel sign was the only parameter before treatment that could predict mRS <2 at 3 months (OR, 8.7; 95% CI, 1.1-69.4; P > .04). CONCLUSIONS: Our study strongly suggests that the susceptibility vessel sign on MR imaging before treatment is predictive of favorable clinical outcome for patients presenting with anterior circulation acute stroke and treated with mechanical thrombectomy.