Yong-Woo Kim MD, PhD, Presenter: Nothing to Disclose

Susceptibility-weighted MR image (SWI) is suitable for venous imaging. Venous side is the unknown area in the hemodynamics of brain infarction. The purpose of this study is to evaluate the venous aspect in acute brain infarction through the clinical and animal studies.

In the clinical study, 284 patients with acute infarction were evaluated with MR images including DWI and SWIs. According to the lesion size, stage and site, the infarction was classified. The venous structures were analyzed qualitatively for the caliber difference between ipsilateral and contralateral hemispheres. In the animal study, the acute infarction in 17 cat brains was made with bolus infusion of triolein 2.5 ml through internal carotid artery. The MR images including DWI, ADC map, SWI, and PWIs were obtained serially at 2 hours (n=17), 1 (n=11) and 4 days (n=4) after infusion. The MR images were evaluated qualitatively and quantitatively. Qualitative evaluation was performed by assessing the signal intensity of the serial MR images. Quantitative assessment was performed by comparing the CBV, CBF, MTT, and TTP of the lesions to the contralateral normal side calculated on PWI. .

In clinical study, focal dilatation of the venous system adjacent to infarction was observed 54.1% (137/284) in large infarctions, and 19.3% (6/31) in small infarctions on SWI. Venous dilatation was demonstrated in 63.1% (118/187) of mixed infarction, 25.7% (25/97) of the deep gray matter infarction, and 59.2% (58/98) in hyperacute and 45.7% (85/186) in acute infarction. In animal study, the qualitative evaluation showed acute infarction in the first two gyri of lesion side on DWI and the ADC map images. The venous system of cat brain with infarction was obscured at 2 hours, re-appeared at 1 day, and engorged at 4 days on SWI. The quantitative evaluation revealed increase MTT and TTP ratios, and decrease CBV and CBF ratios on PWIs.  

The venous dilatation on SWI seems to be dependent on size, site and stage of infarctions in clinical study. The venous dilatation on SWI seems to be related with increase MTT ratio and decrease CBF ratio on time course in animal study. SWI may be helpful for the study of venous hemodynamics of brain infarction.

SWI will be useful to evaluate the venous hemodynamics of cerebral infarction.

Kim, Y, Focal Venous Dilatation in Acute Brain Infarction Studied with SWI: Clinical and Animal Studies.  Radiological Society of North America 2011 Scientific Assembly and Annual Meeting, November 26 - December 2, 2011 ,Chicago IL. http://archive.rsna.org/2011/11016189.html