Objective: Asymmetrical cortical vein sign (ACVS) shown on susceptibility-weighted imaging (SWI) can reflect regional hypoperfusion. We investigated if ACVS could predict the cerebral collateral circulation (CC) as assessed by digital subtraction angiography (DSA) in acute ischemic stroke patients with ipsilateral severe stenosis/occlusion of the anterior circulation. Methods: Clinical data and imaging data of 62 acute ischemic stroke patients with ipsilateral severe stenosis or occlusion of the anterior circulation confirmed by DSA were collected retrospectively. Participants underwent magnetic resonance imaging, including an SWI sequence. ACVS was defined as more and/or larger venous signals in the cerebral cortex of one side of SWI than that in the contralateral side. ACVS was measured using the Alberta Stroke Program Early Computed Tomography score based on SWI. The grading of the cerebral CC was judged using DSA. Results: Of the 62 patients, 30 patients (48.4%) had moderate-to-severe ACVS. According to DSA assessment, 19 patients (30.6%) had a good CC (grade 3-4), and 43 (69.4%) patients had a poor-to-moderate CC (grade 0-2). Among the 30 patients with moderate-to-severe ACVS, only three (10%) patients had a good CC, and 27 (90%) patients had a poor-to-moderate CC; among the 32 patients with none or mild ACVS, 16 (50%) of them had a good CC, and the other 50% had a moderate-to-severe CC. We constructed two logistic regression models with ACVS grading and none or mild ACVS entered into the models, respectively, together with age and large-artery occlusion. In model 1, no ACVS (compared with severe ACVS; OR = 40.329, 95%CI = 2.817-577.422, P = 0.006), mild ACVS (compared with severe ACVS; OR = 17.186, 1.735-170.224, 0.015) and large-artery occlusion (OR = 45.645, 4.603-452.592, 0.001) correlated with a good CC. In model 2, none or mild ACVS (OR = 36.848, 95%CI = 5.516-246.171, P < 0.001) was significantly associated with a good CC as judged by DSA, adjusted by age and large-artery occlusion. Conclusions: Cortical venous changes in SWI may be a useful indicator for the cerebral CC as confirmed by DSA.

中文翻译：

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磁敏感加权成像的皮质静脉变化预测了数字减影血管造影证实的脑侧支循环。

目的：磁敏感加权成像 (SWI) 上显示的不对称皮质静脉征 (ACVS) 可以反映区域灌注不足。我们研究了 ACVS 是否可以通过数字减影血管造影 (DSA) 评估患有同侧前循环严重狭窄/闭塞的急性缺血性卒中患者的脑侧支循环 (CC)。方法：回顾性收集62例经DSA证实的同侧前循环严重狭窄或闭塞的急性缺血性脑卒中患者的临床资料和影像资料。参与者接受了磁共振成像，包括 SWI 序列。ACVS被定义为SWI一侧大脑皮层的静脉信号多于对侧的静脉信号。ACVS 是使用基于 SWI 的艾伯塔中风计划早期计算机断层扫描评分来测量的。使用DSA判断大脑CC的分级。结果：在 62 名患者中，30 名患者 (48.4%) 患有中度至重度 ACVS。根据 DSA 评估，19 名患者 (30.6%) 的 CC 良好（3-4 级），43 名（69.4%）患者的 CC 较差至中度（0-2 级）。在 30 名中度至重度 ACVS 患者中，只有 3 名（10%）患者的 CC 良好，27 名（90%）患者的 CC 为差至中度；在 32 例无 ACVS 或轻度 ACVS 的患者中，其中 16 例（50%）有良好的 CC，另外 50% 有中度至重度的 CC。我们构建了两个具有 ACVS 分级和无或轻度 ACVS 的逻辑回归模型，分别与年龄和大动脉闭塞一起进入模型。在模型1中，没有ACVS（与严重ACVS相比；OR = 40.329, 95%CI = 2.817-577.422, P = 0.006)，轻度 ACVS（与重度 ACVS 相比；OR = 17.186, 1.735-170.224, 0.015）和大动脉闭塞（62.5-170.224, 0.015）和大动脉闭塞（62.5.45.454.54.50.309 ) 与良好的 CC 相关。在模型 2 中，根据 DSA 判断，无或轻度 ACVS（OR = 36.848，95%CI = 5.516-246.171，P < 0.001）与良好的 CC 显着相关，根据年龄和大动脉闭塞进行调整。结论：SWI 的皮质静脉变化可能是 DSA 证实的脑 CC 的有用指标。根据年龄和大动脉闭塞情况进行调整。结论：经 DSA 证实，SWI 皮质静脉变化可能是脑 CC 的有用指标。根据年龄和大动脉闭塞情况进行调整。结论：经 DSA 证实，SWI 皮质静脉变化可能是脑 CC 的有用指标。