Purpose

Occlusion or significant stenosis of the internal carotid artery (ICA) in the cervical segment is commonly associated with a poststenotic decrease in the downstream blood flow and perfusion. Fluid attenuated inversion recovery (FLAIR) vascular hyperintensities (FVH) are a phenomenon that represents slow arterial blood flow. In this study, we investigated the frequency and extent of FVH in the distal ICA in patients with proximal ICA stenosis.

Methods

We analyzed the magnetic resonance imaging (MRI) findings in 51 patients with a total of 60 cervical ICA stenoses with special focus on the frequency and extent of FVH in the area of the petrous segment of the ICA on FLAIR images and correlated these with Doppler/duplex sonography results.

Results

In 46 (76.7%) patients with ICA stenosis, FVH could be detected in the petrous segment of the ICA: in 19 (41.3%) patients a thin hyperintense rim near the vessel wall (grade 1), in 24 (52.2%) patients a strong hyperintense rim near the vessel wall (grade 2), and in 3 (6.5%) patients a hyperintense filling of the entire lumen (grade 3) was observed. The extent of FVH in the ICA in the petrous segment showed a high negative correlation with the poststenotic flow velocity (Spearman correlation, R = –0.75, p < 0.001), and moderate correlation with the degree of ICA stenosis (Spearman correlation, R = 0.51, p< 0.001).

Conclusion

An FVH in the petrous ICA is commonly seen among patients with steno-occlusive disease in proximal ICA and could therefore be useful to recognize a proximal ICA stenosis even on FLAIR images.

中文翻译：

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FLAIR 血管高信号表明 ICA 狭窄的狭窄后血流缓慢。

目的

颈段内颈内动脉 (ICA) 的闭塞或显着狭窄通常与下游血流和灌注的狭窄后减少有关。流体衰减反转恢复 (FLAIR) 血管高信号 (FVH) 是一种代表动脉血流缓慢的现象。在这项研究中，我们调查了近端 ICA 狭窄患者远端 ICA 中 FVH 的频率和范围。

方法

我们分析了 51 名患者的磁共振成像 (MRI) 结果，共 60 处颈椎 ICA 狭窄，特别关注 FLAIR 图像上 ICA 岩段区域 FVH 的频率和范围，并将这些与多普勒/双重超声检查结果。

结果

在 46 名 (76.7%) ICA 狭窄患者中，可以在 ICA 岩段检测到 FVH：19 名 (41.3%) 患者在血管壁附近有薄的高信号边缘（1 级），24 名 (52.2%) 患者血管壁附近有强烈的高信号边缘（2 级），并且在 3 名（6.5%）患者中观察到整个管腔的高信号填充（3 级）。岩段 ICA 中 FVH 的范围 与狭窄后流速呈高度负相关（Spearman 相关，R = –0.75，p < 0.001），与 ICA 狭窄程度呈中度相关（Spearman 相关，R = 0.51，p < 0.001）。

结论

岩质 ICA 中的 FVH 常见于 ICA 近端狭窄闭塞性疾病的患者，因此即使在 FLAIR 图像上也可用于识别近端 ICA 狭窄。