Abstract:

Objective To investigate the related factors leading to asymmetrical prominent veins sign (APVS) on SWI in patients with acute ischemic stroke (AIS). 

Methods This prospective study enrolled the consecutive patients with AIS admitted to the Affiliated Yantai Yuhuangding Hospital of Qingdao University between July 2021 and March 2022. All patients completed multimodal MRI within 72 hours of symptoms onset, including DWI, SWI and MRA sequences. Patients were divided into APVS positive and negative groups according to having APVS on SWI or not. The baseline clinical data and 90-day poor prognosis (mRS>1) were collected. Multivariate logistic regression analysis was used to determine the factors affecting the presence of APVS. 

Results A total of 80 patients were enrolled, with APVS on SWI occurring in 28 patients (35%). Univariate analysis showed that the NIHSS score [8 (4-11) vs. 2 (10-6), P<0.001], the proportion of severe intracranial large artery stenosis or occlusion (57.1% vs. 3.8%, P<0.001), anterior circulation infarction (92.9% vs. 65.4%, P=0.007), and poor prognosis (71.4% vs. 30.8%, P<0.001) in APVS positive group were higher than those in APVS negative group. Multivariate logistic regression analysis showed that anterior circulation infarction (OR 7.665, 95%CI 1.089-53.959, P=0.041), and severe intracranial large artery stenosis or occlusion (OR 20.928, 95%CI 3.420-128.056, P=0.001) were independent influencing factors of the occurrence of APVS. 

Conclusions Patients with anterior circulation infarction and severe intracranial large artery stenosis or occlusion were more likely to have APVS on SWI.

Key words: Asymmetrical prominent veins sign; Magnetic resonance imaging; Susceptibility weighted imaging; Acute ischemic stroke

摘要：

目的 探讨缺血性卒中（acute ischemic stroke，AIS）急性期头颅MRI SWI序列上不对称突出静脉征（asymmetrical prominent veins sign，APVS）的发生率及其影响因素。 

方法 前瞻性连续收集2021年7月-2022年3月在青岛大学附属烟台毓璜顶医院就诊的AIS患者。所有患者均在发病72 h内完成多模式头颅MRI检查，包括DWI、SWI和MRA序列，根据SWI上是否出现APVS，将患者分为APVS阳性组和APVS阴性组，收集患者年龄、性别、血管危险因素、入院时NIHSS、入院时平均动脉压、发病至MRI检查时间、颅内血管狭窄情况、梗死部位、TOAST分型及90 d不良预后（mRS＞1分）等资料，采用单因素分析和多因素logistic回归分析APVS的影响因素。 

结果 共入组80例患者，其中28例（35%）SWI序列上出现APVS。单因素分析显示，APVS阳性组患者的入院时NHISS[8（4～11）分 vs. 2（1～6）分，P＜0.001]、颅内血管重度狭窄或闭塞比例（57.1% vs. 3.8%，P＜0.001）、前循环梗死比例（92.9% vs. 65.4%，P=0.007）以及90 d不良预后比例（71.4% vs. 30.8%，P＜0.001）均高于APVS阴性组。多因素logistic回归分析显示，与APVS独立相关的因素为前循环梗死（OR 7.665，95%CI 1.089～53.959，P=0.041）、颅内血管重度狭窄或闭塞（OR 20.928，95%CI 3.420～128.056，P=0.001）。 

结论 前循环梗死、颅内血管重度狭窄或闭塞的AIS患者SWI序列上更易出现APVS。

关键词: 不对称突出静脉征; 磁共振成像; 磁敏感加权成像; 急性缺血性卒中