Evaluation of GRADIENT Echo (۱,۵ tesla) Sequence in Patients with CVA that Occurred up to ۷۲ Hours

Background and Aim: based on various studies ,  GRE (gradient echo)(۳ TESLA) can  detect pneumobra and also shows the association of SVS with cardiac origin in GRE t۲*(according totransesophageal echo),so  we intend to consider the ability of GRE with ۱.۵ Tesla in the detection of pneumobra and also the association of SVS(susceptibility vessel sign ) with atrial fibrilation For the first time,so, we evaluated  the association of SVS with atrial fibrillation in patients with stroke who have been referred  within ۷۲ hours. Materials and Methods: The statistical population consisted of ۲۰ patients over the age of ۱۸ years who  referred to Valiasr Hospital in Zanjan with cva diagnosis , based on the  absence of bleeding in BRAIN CT ,different MRI sequences Waere done for them.Due to the fact that this study was a pilot study, sampling method was  in available sampling. Information from various BRAIN MRI sequences including DWI (diffusion-weighted imaging )/ GRE T۲ * / ADC(apparent diffusion coefficient)/ T۱ / T۲ / FLAIR(Fluid-attenuated inversion recovery), presence or absence of atrial fibrilation and NIHSS( National Institutes of Health Stroke Scale)items were collected from clinical examination and ekg , and inserted to  special chart for statistical analysis. Results: A total of ۲۰ patients with ischemic stroke were enrolled in this study, the mean of the infarction area was DWI = ۶۵ml and the mean NIHSS = ۹. GRE T۲ *, ۵۰% of patients with SVS and ۵۰% had no SVS. Of the ۲۰ patients, ۳۵% had AF and ۶۵% had not  AF in the EKG. Of the ۲۰ patients, ۳۵% had subcortical lesions and ۶۵% had cortical lesion in the DWI sequence. GRET۲ * / DWI MATCH was seen in all ۱۳ patients (۶۵%) with cortical lesion in DWI and out of ۷ patients (۳۵%) who had DWI in subcortical lesion only In one patient, DWI / GR E T۲ * MISMATCH was observed and there was no DWI / GRE T۲ * MATCH or MISMACHT in ۶ patients. There was no significant relationship between age and SVS  and between gender and SVSand between AF and SVS. there was a significant relationship between SVS and infarct area in DWI , between SVS and NIHSS,between  cortical lesion in  DWI and SVS.,between the presence of subcortical  infarction region in DWI and the absence of SVS  and  between the presence of RMHV and SVS. Conclusion: Totally, there was a significant relationship between SVS and infarct volume in DWI and between SVS and NIHSS with p value = ۰.۰۰۱, also with p value = ۰.۰۰۳, there was a significant relationship between the presence of cortical infarction in DWI and the SVS sign, subcortical infarction area in the DWI and the absence of SVS and between the presence of RMHV and the SVS sign. With pvalue = ۰.۰۵۷, there was no significant relationship between atrial fibrilation and SVS. However, due to the low power level of the study (۶۷%), it is recommended that this study be repeated with higher volume, which seems to be significantrelationship between these, with increasing number of samples, and therefore probably In the presence of  SVS sign in the GRE T۲ sequence, the cause of stroke may be higher in the cardiac region, especially atrial fibrillation. Therefore, patients who have SVS symptoms but do not have atrial fibrillation in the ECG, are candidates for Holter monitoring.

Keywords:

CVA , GRADIENT echo , GRE susceptibility vessel sign