Interpretation of fluid-attenuated inversion recovery vascular hyperintensity in stroke

Kyung-Yul Lee; Jin Woo Kim; Mina Park; Sang Hyun Suh; Sung Jun Ahn

doi:10.1016/j.neurad.2021.01.009

Interpretation of fluid-attenuated inversion recovery vascular hyperintensity in stroke

J Neuroradiol. 2022 May;49(3):258-266. doi: 10.1016/j.neurad.2021.01.009. Epub 2021 Jan 28.

Authors

Kyung-Yul Lee¹, Jin Woo Kim², Mina Park², Sang Hyun Suh², Sung Jun Ahn³

Affiliations

¹ Department of Neurology, Gangnam Severance Hospital, Yonsei University, College of Medicine, Seoul, Korea.
² Department of Radiology, Gangnam Severance Hospital, Yonsei University, College of Medicine, Seoul, Korea.
³ Department of Radiology, Gangnam Severance Hospital, Yonsei University, College of Medicine, Seoul, Korea. Electronic address: aahng77@yuhs.ac.

PMID: 33515596
DOI: 10.1016/j.neurad.2021.01.009

Abstract

Fluid-attenuation inversion recovery (FLAIR) vascular hyperintensity (FVH) is a common presentation on brain magnetic resonance images of patients with acute ischemic stroke. This sign is known as a sluggish collateral flow. Although FVH represents the large ischemic penumbra and collateral circulation, the clinical significance of FVH has not been established. Varying protocols for FLAIR, treatment differences, and heterogeneity of endpoints across studies have complicated the interpretation of FVH in patients with acute stroke. In this review article, we describe the mechanism of FVH, as well as its association with functional outcome, perfusion-weighted images, and large artery stenosis. In addition, we review the technological variables that affect FVH and discuss the future perspectives.

Keywords: Collateral; FLAIR; FLAIR vascular hyperintensity (FVH); MRI; Perfusion; Stroke.

Publication types

Review

MeSH terms

Brain Ischemia* / complications
Brain Ischemia* / diagnostic imaging
Collateral Circulation
Humans
Ischemic Stroke*
Magnetic Resonance Imaging
Retrospective Studies
Stroke* / complications