Objective To explore the value of FLAIR vascular hyperintensity (FVH) in evaluating the degree
of vascular stenosis, stroke severity and the location of infarction in patients with acute ischemic
stroke (AIS).
Methods A retrospective analysis was performed for the clinical and imaging data of AIS patients
in middle cerebral artery (MCA) territory who were admitted to the Third Hospital of Hebei
Medical University from January 2017 to June 2019. According to the distribution of infarcts in
MCA territory on DWI, the infarcts were divided into perforating artery type, border zone type,
regional type and mixed type. The FVH score (0-7 points) in MCA territory was calculated
according to the method of ASPECT score, and all the patients were divided into FVH ≥4 group
and FVH <4 group. The differences in general information, degree of vascular stenosis, NIHSS
score on admission and infarcts site between the two groups were compared. Spearman correlation
analysis was used to analyze the association between FVH score and artery stenosis degree, and
ROC curve was used to analyze the diagnostic value of FVH score for artery occlusion.
Results A total of 214 patients were analyzed, including 51 patients with FVH ≥4 and 163 patients
with FVH <4. The proportion of border zone infarcts (43.1% vs 20.9%) and intracranial carotid
artery lesions (41.7% vs 22.3%) and the NIHSS score [4 (2-6) vs 3 (1-4)] in FVH ≥4 group were
higher than that in FVH <4 group, while the proportion of perforating artery infarcts was lower than
that in FVH <4 group (19.6% vs 52.8%), all the above differences were statistically significant. The
proportion of artery occlusion in FVH ≥4 group was higher than that in FVH <4 group (54.9% vs
9.2%, P <0.001), and the proportion of mild artery stenosis was lower than that in FVH <4 group
(9.8% vs 54.0%, P <0.001). Spearman analysis showed that FVH score was positively correlated
with the degree of the ipsilateral internal carotid artery or MCA stenosis (r =0.504, P <0.001). ROC
curve analysis indicated that the optimal cut-off value of FVH score for the diagnosis of artery
occlusion was 3 points, the sensitivity was 74.4% and the specificity was 80.1%.
Conclusions For patients with AIS in MCA territory, the FVH score can indirectly evaluate the
degree of intracranial arterial stenosis, and also can reflect stroke severity on admission and infarcts
site.
