Background

The clinical significance of fluid-attenuated inversion recovery vascular hyperintensity (FVH) has not been clarified. The aim of this study was to clarify the effects of FVH on the clinical severity and long-term prognosis of patients with proximal middle cerebral artery (MCA) occlusion or severe stenosis.

Method

Because their clinical and imaging data is not accessible, we excluded the patients being treated with IV thrombolysis or mechanical thrombectomy. Clinical and imaging characteristics were documented in 282 consecutive AIS patients with proximal MCA occlusion or severe stenosis. We assessed clinical severity using the National Institutes of Health Stroke Scale (NIHSS) score and clinical outcomes using mRS scores. The average time interval between symptom onset and imaging was 16–18 h. The FVH score according to FVH-ASPECTS ranged from 0 to 7, based on the numbers of territories where FVH is positive.

Results

FVH was observed in 235 (83.33%) of the AIS patients. The FVH(+) group tended to have more alcoholics (65 [27.66%] vs 6 [12.77%], P = 0.032), a higher NIHSS score on the 7th day (3 [1–6] vs 2 [1–3], P = 0.039), more instances of early neurological deterioration (END) (27 [11.4%] vs 1 [2.12%], P = 0.05), and more patients with MCA occlusion (94 [40.00%] vs 3 [6.38%]). Among the patients with positive FVH, a high FVH score represented severe clinical impairment (higher NIHSS score on admission [P = 0.009] and 7th day since admission [P = 0.02]) and poor clinical outcomes. Spearman’s rank correlations showed that FVH scores were positively correlated with NIHSS scores on admission and NIHSS scores on the 7th day (P = 0.039; P = 0.017, respectively).

Conclusion

In patients with proximal middle cerebral artery (MCA) occlusion or stenosis ≥ 70%, a high FVH score represented severe clinical impairment and poor clinical outcomes. In acute ischemic stroke (AIS) patients with proximal MCA occlusion, a high FVH score represented favorable clinical outcomes.

中文翻译：

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FLAIR血管高血压对临床严重程度和预后的影响：一项对中脑近端狭窄或闭塞的卒中患者的回顾性研究。

背景

液体衰减型反转恢复性血管紧张症（FVH）的临床意义尚未阐明。这项研究的目的是阐明FVH对近端大脑中动脉（MCA）阻塞或严重狭窄的患者的临床严重程度和长期预后的影响。

方法

由于无法获得他们的临床和影像数据，因此我们排除了接受静脉溶栓或机械血栓切除术治疗的患者。临床和影像学特征已记录在282例连续的AIS患者中，这些患者发生近端MCA闭塞或严重狭窄。我们使用美国国立卫生研究院卒中量表（NIHSS）评分评估了临床严重程度，并使用mRS评分评估了临床结局。症状发作和影像学检查之间的平均时间间隔为16-18小时。根据FVH-ASPECTS得出的FVH评分范围为0到7，基于FVH为正的地区数量。

结果

在235名（83.33％）AIS患者中观察到FVH。FVH（+）组倾向于酗酒（65 [27.66％]比6 [12.77％]，P  = 0.032），第7天的NIHSS得分较高（3 [1–6]比2 [1–3] ]，P  = 0.039），更多的早期神经系统恶化（END） 病例（27 [11.4％] vs 1 [2.12％]，P = 0.05），以及MCA闭塞的患者更多（94 [40.00％] vs 3 [6.38] ％]）。其中阳性患者FVH，高得分FVH表示入院严重的临床损伤（更高NIHSS评分[ P  = 0.009]和第7天自入院[ P = 0.02]）和较差的临床结果。Spearman等级相关性显示，入院时FVH分数与入院时NIHSS分数和第7天时NIHSS分数呈正相关（分别为P  = 0.039；P  = 0.017）。

结论

对于近端大脑中动脉（MCA）阻塞或狭窄≥70％的患者，FVH评分高表示严重的临床损害和不良的临床预后。在患有近端MCA闭塞的急性缺血性卒中（AIS）患者中，高FVH评分代表了良好的临床效果。