PURPOSE The clinical significance of FLAIR vascular hyperintensity (FVH), a marker of collateral circulation in ischaemic stroke, remains controversial. We hypothesised that the association between FVH and outcomes varies with the severity of leukoaraiosis (LA), another marker of collaterals, and that their combined significance may vary with time. METHODS We included 459 consecutive patients with middle cerebral artery (MCA) stroke. Proximal and distal FVHs were distinguished based on location. LA was divided into two grades, according to Fazekas scores of 0-2 and 3-6. Symptom-to-MRI time was divided into two categories: ≤ 14 days and ≥ 15 days. RESULTS We found no difference in FVH proportion according to LA grade. Multivariate analysis revealed that LA and FVH status were independently associated with unfavourable outcomes (modified Rankin scale ≥ 2) in patients with symptom-to-MRI times ≤ 14 days (P = 0.008), but not in those with symptom-to-MRI times ≥15 days (P = 0.61). In the group with symptom-to-MRI times ≤14 days, patients with LA 3-6 and FVH(+) (OR, 3.044; 95% CI, 1.116-8.305) were more likely to have unfavourable clinical outcomes compared with patients with LA 0-2 and FVH(+) but not compared with those with LA 0-2 and FVH(-) or LA 3-6 and FVH(-). In addition, FVH location did not influence the relationship between FVH and outcomes. CONCLUSIONS The association between FVH and outcomes was influenced by the degree of LA in the acute but not in the subacute and chronic stages of MCA infarction. FVH predicts clinical outcomes independently only in those with more extensive LA.

中文翻译：

---

FLAIR血管血脂过多与急性MCA中风结局的相关性随白细胞疏松症的严重程度而变化。

目的FLAIR血管高信号（FVH）（缺血性中风侧支循环的标志物）的临床意义仍存在争议。我们假设，FVH与预后之间的关联会随着侧枝的另一标记物白斑病（LA）的严重性而变化，并且它们的综合意义可能会随时间变化。方法我们纳入了459例连续的脑中动脉（MCA）中风患者。根据位置区分近端和远端FVH。根据Fazekas的0-2和3-6分数，洛杉矶分为两个年级。从症状到MRI的时间分为两类：≤14天和≥15天。结果根据LA等级，我们发现FVH比例没有差异。多变量分析显示，症状至MRI时间≤14天（P = 0.008）的患者，LA和FVH状态与不良结局（改良的Rankin评分≥2）独立相关，但与症状至MRI时间无关≥15天（P = 0.61）。在症状至MRI时间≤14天的组中，LA 3-6和FVH（+）（OR，3.044； 95％CI，1.116-8.305）的患者与患有MRI的患者相比，其临床结局更可能较差LA 0-2和FVH（+），但未与LA 0-2和FVH（-）或LA 3-6和FVH（-）比较。此外，FVH的位置不影响FVH与结局之间的关系。结论FVH与预后之间的相关性受MCA梗死急性期而非亚急性期和慢性期LA程度的影响。