Asymmetrically hypointense veins on T2*w imaging and susceptibility-weighted imaging in ischemic stroke

Table 2 Publications using susceptibility-weighted imaging and combining T2*w imaging and susceptibility-weighted imaging

Ref.	n	Field strength	Occluded vessel	Time from onset	Validation method	Results
Ida[23]	62	1.5 T	NS	24 h	DSC-MRI; DWI	IVC were noted in 77.4%, agreement with perfusion defect in all patients
Tong et al[24]	1	NS	MCA	3 d	ADC	Prominent asymmetric medullary veins exceeding the area of the DWI lesion
Mittal et al[25]	1	1.5 T	MCA	2 h	DWI; DSC-MRI	Prominently hypointense cortical veins exceeding the area of the DWI lesion, similar to PWI lesion
Santhosh et al[26]	1	1.5 T	MCA	NS	DWI	Prominent veins exceeding the area of the DWI lesion
Tsui et al[27]	1	NS	MCA	NS	DWI	Prominent hypointense veins exceeding the area of the DWI lesion
Christoforidis et al[28]	6	3 T	MCA	NS	DSC-MRI; DWI	MHV were noted within the MTT lesion while they absent within the DWI lesion
Hingwala et al[29]	1	NS	MCA	NS	DWI	Prominent veins exceeding the area of the DWI lesion
Huisman et al[30]	1	NS	MCA	NS	ADC/DWI	Prominent intramedullary veins exceeding the area of the DWI lesion
Mittal et al[31]	2	1.5 T	MCA	NS	ADC/DWI; DSC-MRI	Prominent hypointense veins exceeding the area of the DWI lesion, similar to PWI lesion
Yen et al[32]	1	NS	MCA	4 d	DWI; DSC-MRI	Prominent venous hypointensities exceeding the area of the DWI lesion, similar to PWI lesion
Kesavadas et al[33]	2	NS	MCA	NS	DSC-MRI; ADC/DWI	Prominent veins exceeding the area of the DWI lesion, similar to PWI lesion
Park et al[34]	82	NS	ICA, MCA	3 d	DSC-MRI; DWI	MHV visible in 73/82 patients, excellent agreement with TTP maps
Lin et al[35]	53	NS	ICA, MCA	12 h	Traditional MRI	Hypointense transmedullary veins predisposed to worse outcome (OR = 2.2)
Meoded et al[36]	2	NS	MCA, ACA	NS	Conventional MRI; DWI	Prominent intramedullary veins were noted within the DWI lesion. In one case prominent sulcal veins matched the area of infarct growth.
Gasparotti et al[37]	1	1.5 T	ICA	NS	DWI; DSC-MRI	SWI lesion exceeded DWI lesion and matched MTT lesion
Yamashita et al[38]	30	3 T	MCA	7 d	DWI; FAIR	Increased venous contrast in 22/30 patients, area similar to hypoperfused tissue
Huang et al[39]	44	3 T	MCA	2 d	DWI; MRA; CT	Prominent veins present in 15/44 patients; Not correlated with haemorrhage or outcome
Kao et al[40]	15	1.5 T	MCA	18 h	DWI; DSC-MRI	MTT-DWI and SWI-DWI mismatch similar to predict infarct growth
Tsai et al[41]	49	NS	NS	3.5-8.5 h	MRI; Clinical	Presence of hypointense veins in all patients with worse outcome and haemorrhagic complications
Meoded et al[42]	8	NS	NS	72 h	DWI	DWI > SWI mismatch found in 1/15 affected regions
Park et al[43]	9	NS	TIA	NS	DWI; DSC-MRI; MRA	4/9 patients with DWI negative TIA showed asymmetric hypointense vessels, in accordance with perfusion deficit and stenosed/occluded vessel
Fujioka et al[44]	1	NS	ICA	10 h	MRI	SWI lesion exceeding DWI lesion matured into infarction
Verschuuren et al[45]	1	NS	MCA, ACA	NS	ADC; CT	SWI lesion exceeding ADC lesion matured into infarction on CT
Meoded et al[46]	1	1.5 T	MCA, PCA	NS	T2; ADC	SWI lesion matches ADC lesion; Mismatch also noted, indicating critical perfusion
Baik et al[47]	19	1.5 Tand 3 T	ICA, MCA, BA	Median 2.5 h	DWI	Prominent veins present in affected territory which disappeared after recanalization (10/10 patients); After recanalization within DWI lesion: Equally prominent in 10/19 patients, small DWI lesions, good clinical outcome (7 d NIHSS median 3.5, 90 d mRS median 0) indicating normalisation; Less prominent in 5/19 patients, large DWI lesions, poor clinical outcome (7 d NIHSS median 13, 90 d mRS median 4) indicating futile reperfusion; Mixed in 4/19 patients, medium DWI lesions, relatively poor outcome (7d NIHSS median 13, 90 d mRS median 2)
Tsai[48]	59	NS	NS	NS	Imaging; Clinical	34 patients improved or stable (clinical, imaging), 25 worse; SWI correlated with poor prognosis
Sohn et al1 [49]	65	NS	Anterior circulation	12 h	Perfusion MRI	Asymmetrical HVS in 98% (SWI) and 74% (T2*w)

¹Publication combining T2*w imaging and susceptibility-weighted imaging. NS: Not stated; ICA: Internal carotid artery; MCA: Middle cerebral artery; ACA: Anterior cerebral artery; ADC: Apparent diffusion coefficient; BA: Basilar artery; FAIR: Flow sensitive alternating inversion recovery; MRA: Magnetic resonance angiography; CT: Computed tomography; PCA: Posterior cerebral artery; IVC: Increased vessel contrast; TIA: Transient ischemic attack; DWI: Diffusion-weighted image; PWI: Perfusion-weighted image; MTT: Mean transit time; DSC-MRI: Dynamic susceptibility-contrast magnetic resonance imaging; NIHSS: National Institute of Health Stroke Score; mRS: Modified ranking scal; SWI: Susceptibility-weighted imaging; HVS: Hypointense vessel sign; MHV: Multiple hypointense vessels.