MRI quantitative T2* mapping on thrombus to predict recanalization after endovascular treatment for acute anterior ischemic stroke

J Neuroradiol. 2017 Jul;44(4):241-246. doi: 10.1016/j.neurad.2017.03.006. Epub 2017 May 3.


Background: In anterior acute ischemic stroke (AAIS) treated with endovascular treatment (EVT), the susceptibility vessel sign (SVS+ or SVS-) is related to recanalization results (TICI 2b/3) and clinical outcome. However, a binary qualitative assessment of thrombus using SVS does not reflect its complex composition. Our aim was to assess whether a quantitative MRI marker, Thrombus-T2* relaxation time, may be assessable in clinical routine and may to predict early successful recanalization after EVT, defined as a TICI 2b/3 recanalization obtained in 2 attempts or less.

Material and methods: Thrombus-T2* relaxation time was prospectively obtained from consecutive AAIS patients treated by EVT (concomitant aspiration and stent retriever). Quantitative values were compared between early recanalization and late or unsuccessful recanalization.

Results: Thirty patients with AAIS were included and Thrombus-T2* relaxation time was obtained in all patients. Earlier TICI 2b/3 recanalization were obtained in 22 patients (73%) and was significantly associated with SVS+ (1/8 vs. 16/22, P=0.01) and a shorter Thombus-T2* relaxation time (mean SD, range: 257, 18-50ms vs. 45 9, 35-60ms, P<0.001).

Conclusion: A new quantitative MRI biomarker, the Thrombus-T2* relaxation time is assessable in clinical routine. In a preliminary study of 30 patients, a shorter Thombus-T2* relaxation time is related to earlier recanalization after EVT using combination of stent retriever and aspiration.

Keywords: Mapping; Quantitative; Stroke; T2*; Thrombus.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Brain Ischemia / diagnostic imaging*
  • Brain Ischemia / therapy*
  • Brain Mapping
  • Cerebral Angiography
  • Cerebral Revascularization / methods*
  • Endovascular Procedures*
  • Female
  • Humans
  • Magnetic Resonance Imaging / methods*
  • Male
  • Middle Aged
  • Retrospective Studies
  • Stents
  • Stroke / diagnostic imaging*
  • Stroke / therapy*
  • Suction
  • Thrombectomy / instrumentation
  • Thrombosis / therapy*
  • Treatment Outcome