Purpose

Migraine with aura (MwA) in the emergency setting is common and sometimes difficult to distinguish from mimicking conditions. Susceptibility weighted imaging (SWI), a magnet resonance (MR) technique is sensitive to deoxygenated hemoglobin in cerebral veins and depicts these according to their level of oxygenation. Our study aimed at evaluating the frequency of regions of prominent focal veins (PFV) on SWI in the acute phase.

Methods

Between 2011 and 2018 we evaluated symptoms and MR imaging of adult patients with acute MwA attacks (< 5 days after onset of symptoms). Abnormal imaging was visually scored in 12 ROIs on both hemispheres distributed on 3 slices. The score ranged from 0 to 3.

Results

In all, 638 patients (436 female) mean age 37.39 years (18–89 ± 14.13) were included. Susceptibility weighted imaging was abnormal in 18.8% of patients. The inferior and posterior medial temporal lobe and the occipital lobe were most often affected. Susceptibility weighted imaging was more likely abnormal when MR was performed within 24 hours with an average around 5 hours after symptom onset. The side of aura symptoms and hemispheric imaging alteration in patients with abnormal SWI was highly significant (p < 0.001).

Conclusion

In the acute episode of MwA, SWI imaging can show a combination of increased deoxygenation. The results may indicate linking PFV to MwA.

中文翻译：

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磁敏感加权成像在有先兆的急性偏头痛中的神经血管解偶联成像

目的

在紧急情况下，有先兆的偏头痛 (MwA) 很常见，有时很难与模拟情况区分开来。磁化率加权成像 (SWI) 是一种磁共振 (MR) 技术，对脑静脉中的脱氧血红蛋白敏感，并根据其氧合水平对其进行描述。我们的研究旨在评估急性期 SWI 上突出局灶静脉 (PFV) 区域的频率。

方法

在 2011 年至 2018 年期间，我们评估了患有急性 MwA 发作（症状发作后 5 天）的成年患者的症状和 MR 成像。在分布在 3 个切片上的两个半球的 12 个 ROI 中对异常成像进行视觉评分。分数范围从 0 到 3。

结果

总共包括 638 名患者（436 名女性），平均年龄 37.39 岁（18-89 ± 14.13）。18.8% 的患者的磁敏感加权成像异常。下、后内侧颞叶和枕叶最常受累。在 24 小时内（平均在症状出现后 5 小时左右）进行 MR 时，磁敏感加权成像更可能出现异常。SWI异常患者的先兆症状侧和大脑半球影像学改变具有高度显着性（p < 0.001）。

结论

在 MwA 的急性发作中，SWI 成像可以显示脱氧增加的组合。结果可能表明将 PFV 与 MwA 联系起来。